OpenMed/multicare-articles huggingface dataset:
The Creeping Attachment Induced Technique (CAIT) in Natural and Restored Teeth: Case Reports with 24 Months of Follow-Up
Authors: Michele Perelli, Roberto Abundo, Giuseppe Corrente, Paolo Giacomo Arduino
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

This article describes a nonsurgical approach for treating gingival recessions and increasing gingival thickness around the natural teeth. Two female patients, presenting gingival recessions at the maxillary frontal teeth, were treated. Patient #1 had a discrepancy among the central maxillary incisors' gingival margin, and tooth UL1 needed to be restored. Patient #2 presented a buccal gingival recession at tooth UL3. In both cases, the sulcular gingival margin was gently disephitelized with a diamond bur leaving the soft tissue healing by itself. After 4 weeks, the procedure was reperformed. After 6 months, the gingival margins appeared thicker and a creeping attachment was achieved in both cases, obtaining gingival symmetry, related to the adjacent or contralateral teeth, and root coverage. Gingival asymmetry, gingival recessions, and gingival thickness may be improved by means of a guided gentle nonsurgical stimulation, providing creeping attachment in the natural and also restored teeth, with a healthy and stable tissue after 24 months of follow-up.
Severe bilateral amyotrophic neuralgia associated with major dysphagia secondary to acute hepatitis E
Authors: Xavier Moisset, Nicolas Vitello, Elodie Bicilli, Romain Courtin, Anna Ferrier, Frederic Taithe, Clément Lahaye, Ali Ait Hssain, Cyril Garrouste, Clavelou Pierre
Journal: F1000Res (2013)

Introduction:
Several acute neurological syndromes can be triggered by immune events. Hepatitis E virus (HEV), an emerging infectious disease, can be one of these triggers.
Case report:
We report the case of a 36-year-old man that presented nausea and a dull abdominal pain for a week and then felt an acute neuralgic pain involving both shoulders that lasted for 8 to 10 hours. Immediately after, the patient presented a severe bilateral muscular weakness of the proximal part of both upper limbs, corresponding to an amyotrophic neuralgia. Two days after the shoulder pain, the patient presented a dysphagia necessitating tube feeding. A blood sample confirmed hepatitis caused by hepatitis E virus (HEV; genotype 3F). Oral feeding resumed progressively after five months. The patient was fully independent for the activities of daily living but was still unable to work after six months.
Conclusion:
Amyotrophic neuralgia and hepatitis E are both under-diagnosed. It is noteworthy that HEV can trigger amyotrophic neuralgia. Antiviral drugs, oral steroids and intravenous immunoglobulins can be proposed, but the optimal treatment has not yet been determined.
Case Report: A Novel GJB2 Missense Variant Inherited From the Low-Level Mosaic Mother in a Chinese Female With Palmoplantar Keratoderma With Deafness
Authors: Xinyuan Tian, Chuan Zhang, Bingbo Zhou, Xue Chen, Xuan Feng, Lei Zheng, Yupei Wang, Shengju Hao, Ling Hui
Journal: Front Genet (2022)
Keywords: gjb2 gene, dominant variant, hearing loss, mosaicism, palmoplantar keratoderma
MeSH terms: Case Reports

Dominant variants in the gap junction beta-2 (GJB2) gene may lead to various degrees of syndromic hearing loss (SHL) which is manifest as sensorineural hearing impairment and hyperproliferative epidermal disorders, including palmoplantar keratoderma with deafness (PPKDFN). So far, only a few GJB2 dominant variants causing PPKDFN have been discovered. Through the whole-exome sequencing (WES), a Chinese female patient with severe palmoplantar hyperkeratosis and delayed-onset hearing loss has been identified. She had a novel heterozygous variant, c.224G>C (p.R75P), in the GJB2 gene, which was unreported previously. The proband's mother who had a mild phenotype was suggested the possibility of mosaicism by WES (∼120×), and the ultra-deep targeted sequencing (∼20,000×) was used for detecting low-level mosaic variants which provided accurate recurrence-risk estimates and genetic counseling. In addition, the analysis of protein structure indicated that the structural stability and permeability of the connexin 26 (Cx26) gap junction channel may be disrupted by the p.R75P variant. Through retrospective analysis, it is detected that the junction of extracellular region-1 (EC1) and transmembrane region-2 (TM2) is a variant hotspot for PPKDFN, such as p.R75. Our report reflects the important and effective diagnostic role of WES in PPKDFN and low-level mosaicism, expands the spectrum of the GJB2 variant, and furthermore provides strong proof about the relevance between the p.R75P variant in GJB2 and PPKDFN.
Case Report: Bilateral diaphragmatic dysfunction due to Borrelia Burgdorferi
Authors: Suhail Basunaid, Chris van der Grinten, Nicole Cobben, Astrid Otte, Roy Sprooten, Rohde Gernot
Journal: F1000Res (2014)
Keywords: borrelia burgdorferi, lyme disease, diaphram, hypoventilation

Summary:
In this case report we describe a rare case of bilateral diaphragmatic dysfunction due to Lyme disease.
Case report:
A 62-years-old male presented to the hospital because of flu-like symptoms. During initial evaluation a bilateral diaphragmatic weakness with orthopnea and nocturnal hypoventilation was observed, without a known aetiology. Bilateral diaphragmatic paralysis was confirmed by fluoroscopy with a positive sniff test. The patient was referred to our centre for chronic non-invasive nocturnal ventilation (cNPPV). Subsequent investigations revealed evidence of anti- Borrelia seroactivity in EIA-IgG and IgG-blot, suggesting a recent infection with Lyme disease, and resulted in a 4-week treatment with oral doxycycline. The symptoms of nocturnal hypoventilation were successfully improved with cNPPV. However, our patient still shows impaired diaphragmatic function but he is no longer fully dependent on nocturnal ventilatory support. Conclusion:
Lyme disease should be considered in the differential diagnosis of diaphragmatic dysfunction. It is a tick-borne illness caused by one of the three pathogenic species of the spirochete Borrelia burgdorferi, present in Europe. A delay in recognizing the symptoms can negatively affect the success of treatment. Non-invasive mechanical ventilation (NIV) is considered a treatment option for patients with diaphragmatic paralysis.
Small Bowel Obstruction Secondary to Intussuscepted Meckel's Diverticulum in an Adult
Authors: Daniel John Marascia
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Intussusception secondary to inverted Meckel's diverticulum resulting in intestinal obstruction is rare. The following is a case report that discusses a 29-year-old female who posed diagnostic uncertainty for the treating surgical team and ultimately underwent emergency surgery for the management of intestinal obstruction. Small bowel intussusception was diagnosed preoperatively on abdominal computer tomography (CT). At operation, it was found to be secondary to inverted Meckel's diverticulum with histopathology confirming the diagnosis.
Anesthetic management using peripheral nerve block in patients with factor XI deficiency: a case report
Authors: Sachio Yoshikawa, Isao Kumano, Yasushi Satoh, Shinya Yufune
Journal: JA Clin Rep (2016)
Keywords: anesthetic management, bleeding tendency, factor xi deficiency

Factor XI deficiency is rare but may cause life-threatening bleeding during the perioperative period. The clinical manifestation of factor XI deficiency is characterized by bleeding tendency. This unpredictable bleeding tendency makes anesthetic management difficult. We report a case of a partial duodenectomy in a patient with factor XI deficiency. The patient was scheduled for duodenectomy because of a duodenal tumor. When checked for coagulation before surgery, the patient was found to have a remarkably prolonged activated partial thrombin time, and further investigation revealed factor XI deficiency. Fresh frozen plasma was transfused before surgery, and general anesthesia and peripheral nerve block were performed. In the present case of factor XI deficiency, supplementation with clotting factor and proper anesthetic management were important to prevent severe complications.
Unusual clinical and pathological features in pemphigus vulgaris: a potential diagnostic pitfall
Authors: Rosario Caltabiano, Gaetano Magro, Lidia Puzzo, Enrico Vasquez, Rocco De Pasquale
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury.
Case report and literature review: thyroid carcinoma showing intrathyroid thymic carcinoma
Authors: Ye Yuan, Changshu Ke, Guopeng Zhang, Jun Zhang, Qianxia Li
Journal: Front Oncol (2022)
Keywords: case report, intrathyroid thymic carcinoma (ittc), lenvatinib, literature review, tyrosine kinase inhibitor
MeSH terms: Case Reports

Background:
Intrathyroid thymic carcinoma (ITTC) is a rare malignancy of the thyroid gland with histological and immunophenotypic resemblance to thymic carcinoma. Surgery combined with adjuvant radiotherapy improves the survival of patients with ITTC. However, for patients with extensive metastases, there is currently no effective treatment. Chemotherapy is an option but has not demonstrated improved patient survival.
Methods and results:
A female patient presented with metastases to the pleura, lung, and bone 16 years after surgery for ITTC. As radiotherapy and chemotherapy failed to control the recurrent disease, lenvatinib treatment was initiated. After 3 months, positron emission tomography/computed tomography showed a substantial reduction of all metastatic lesions and decreased tumor metabolism. The patient continues to receive lenvatinib and remains well and symptom-free.
Conclusion:
For patients with ITTC who have progressive, life-threatening metastases, lenvatinib represents a valuable salvage therapy that may offer a sustained reduction in tumor burden and maintenance of quality of life.
Spontaneous tension hemothorax in a severe COVID-19 patient receiving ECMO therapy: The other side of COVID-19-associated coagulopathy
Authors: Kanin Thammavaranucupt, Tanapat Tassaneyasin, Pongdhep Theerawit, Yuda Sutherasan, Pimwatana Pinsem, Supawadee Suppadungsuk, Nithita Nanthatanti, Suppachok Kirdlarp, Somnuek Sungkanuparph, Sirawat Srichatrapimuk
Journal: Respir Med Case Rep (2022)
Keywords: covid-19, ecmo, hemothorax, pulmonary embolism
MeSH terms: Case Reports

As opposed to widely recognized Coronavirus Disease 2019 (COVID-19)-associated thrombotic events, the unusual but serious bleeding complications in COVID-19 patients are worth-mentioned. Here, we describe a 44-year-old man afflicted by COVID-19 pneumonia with acute respiratory distress syndrome (ARDS) and submassive pulmonary embolism. The patient's condition initially improved with the prescription of ECMO, tocilizumab, and hemoadsorption, however, he later developed spontaneous tension hemothorax, which is considered rare but devastating in the setting of COVID-19. While the exact pathogenesis of COVID-19-associated bleeding events remains poorly understood, we aim to highlight the other aspect of coagulation dysfunction potentially caused by COVID-19.
Add-On Therapy with Ertapenem in Infections with Multidrug Resistant Gram-Negative Bacteria: Pediatric Experience
Authors: Sevgen Tanır Basaranoglu, Yasemin Ozsurekci, Kubra Aykac, Kamile Oktay Arıkan, Ayse Buyukcam, Ali Bulent Cengiz, Mehmet Ceyhan, Ates Kara
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Optimal therapy for infections with carbapenem resistant GNB is not well established due to the weakness of data. Patients presenting with bloodstream infections caused by multidrug resistant Klebsiella pneumoniae were treated with a combination treatment. Optimal therapy for infections with carbapenem resistant Gram-negative bacteria is a serious problem in pediatric patients. We presented three cases who were successfully treated with addition of ertapenem to the combination treatment for bacteremia with multidrug resistant Klebsiella pneumoniae. Dual carbapenem treatment approach is a new approach for these infections and requires more data in children.
A Rare Case of Primary Peritoneal Carcinoma With Large Bowel Metastasis
Authors: Aishwarya Jangam, Vanitha Math
Journal: Cureus (2023)
Keywords: case presentation, epithelial ovarian cancer, metastasis to the colon, presentation, primary peritoneal carcinoma, rare cancer
MeSH terms: Case Reports

Primary serous peritoneal carcinoma (PPC) is a rare malignancy often presenting with a significant disease burden and a poor prognosis. A 65-year-old female was seen in the surgical outpatient clinic with a two-month history of weight loss, altered bowel habits and a CT scan characterizing a heterogenous right paracolic gutter mass and suspicious liver lesions. At colonoscopy, a prominent appendiceal orifice was biopsied to be poorly differentiated carcinoma favouring gynaecological tract origin. The patient was admitted with an acute small bowel obstruction secondary to progression of metastases and underwent neoadjuvant chemotherapy with a near complete response on repeat staging. A debulking hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy and small bowel nodule excision were performed. The diagnosis of PPC was confirmed when no malignancy was found in the pelvic organs. The presence of intraluminal colonic metastasis with PPC is exceedingly rare with this being only the third such case in the literature.