OpenMed/multicare-articles huggingface dataset:
The Use of TADs in the Mandibular Arch to Prevent Proclination of the Lower Incisors during the Use of the Mini Scope Herbst Appliance
Authors: Domenico Aiello, Angelo Finamore, Andrea Scribante, Michele Mario Figliuzzi, Sergio Paduano
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Class II malocclusions are the most frequent within the Italian population. Normally, these malocclusions are caused by a reduction in a mandibular component whose functional stimulus is still very much cause for debate. The negative effect of all types of Class II functional appliances is in the proclination of the lower incisors, which, in subjects whose incisors are already labially inclined, must be checked at all times to avoid serious consequences to these elements. In this case study, a girl aged 14 years and 5 months presented with Class II malocclusion, 2nd division with a convex profile and a visibly retruded chin. The lower incisors presented a marked proclination (-1/Go-Gn ini = 107.7°) in a brachyfacial patient. To avoid further inclination of the lower incisors a Herbst appliance was mounted in two separate sittings. The first part of the appliance including the tubes was mounted to the upper jaw allowing the vestibularisation of the upper incisors in order to increase the overjet. Once this was obtained the lower part of the appliance was mounted together with the telescopic arms associated with two temporary anchorage devices (TADs) in positions 36-37 and 46-47, and an anterior section 33-43 with distal loop to which two double metallic ligatures were anchored at the TADs to contrast the negative effect of the appliance. At the end of the first functional phase, the treatment was refined using MBK fixed therapy to finish the case. The orthodontic therapy led to a visible improvement of the profile and the achievement of a first-class dental-skeletal result on both sides. From the cephalometric evaluation carried out immediately after the Herbst appliance treatment at time T1 and at the end of the orthodontic therapy T2 it was possible to verify a slight increase in the inclination of the lower incisors (-1/Go-Gn fin = 108°). In conclusion, it can be said that the use of the skeletal anchorage avoided, in this case, the proclination effect in the lower incisors due to the use of a Herbst appliance.
Conservative management of segmental infarction of the greater omentum: a case report and review of literature
Authors: Ramawad Soobrah, Mohammad Badran, Simon G Smith
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Segmental omental infarction (SOI) is a rare cause of acute abdominal pain. Depending on the site of infarction, it mimics conditions like appendicitis, cholecystitis, and diverticulitis. Before the widespread use of Computed Tomography (CT), the diagnosis was usually made intraoperatively. SOI produces characteristic radiological appearances on CT scan; hence, correct diagnosis using this form of imaging may prevent unnecessary surgery. We present the case of a young woman who was treated conservatively after accurate radiological diagnosis.
Case Report: Metagenomic Next-Generation Sequencing in Diagnosis of Legionella pneumophila Pneumonia in a Patient After Umbilical Cord Blood Stem Cell Transplantation
Authors: Yangyan Wang, Yuanyuan Dai, Huaiwei Lu, Wenjiao Chang, Fan Ma, Ziran Wang, Zhican Liu, Xiaoling Ma
Journal: Front Med (Lausanne) (2021)
Keywords: legionella pneumophila, hospital acquired, metagenomic next-generation sequencing, myelodysplastic syndrome, umbilical cord blood stem cell transplantation
MeSH terms: Case Reports

We report a case of hospital-acquired Legionella pneumonia that was detected by metagenomic next-generation sequencing (mNGS) of blood from a 7-year-old girl after umbilical cord blood stem cell transplantation (UCBT) with myelodysplastic syndrome. UCBT is traditionally associated with an increased risk of infection, particularly during the first 3 months after transplantation. Controlling interstitial pneumonia and severe infection is the key to reducing patient mortality from infection. Legionella pneumophila can cause a mild cough to rapidly fatal pneumonia. After mNGS confirmed that the pathogen was L. pneumophila, azithromycin, cefoperazone sulbactam, and posaconazole were used for treatment, and the patient's temperature decreased and remained normal. The details of this case highlight the benefits of the timely use of metagenomic NGS to identify pathogens for the survival of immunocompromised patients.
Fatality after deliberate ingestion of the pesticide rotenone: a case report
Authors: David Michael Wood, Hadi Alsahaf, Peter Streete, Paul Ivor Dargan, Alison Linda Jones
Journal: Crit Care (2005)
MeSH terms: Insecticides / poisoning, Rotenone / poisoning, Case Reports, Fatal Outcome, Female, Glasgow Coma Scale, Humans, Middle Aged, Insecticides, Rotenone

Rotenone is a pesticide derived from the roots of plants from the Leguminosae family. Poisoning following deliberate ingestion of these plant roots has commonly been reported in Papua New Guinea. However, poisoning with commercially available rotenone in humans has been reported only once previously following accidental ingestion in a 3.5-year-old child. Therefore, the optimal management of rotenone poisoning is not known. After deliberate ingestion of up to 200 ml of a commercially available 0.8% rotenone solution, a 47-year-old female on regular metformin presented with a reduced level of consciousness, metabolic acidosis and respiratory compromise. Metformin was not detected in premortem blood samples obtained. Despite intensive supportive management, admission to an intensive care unit, and empirical use of N-acetylcysteine and antioxidant therapy, she did not survive. Poisoning with rotenone is uncommon but is potentially fatal because this agent inhibits the mitochondrial respiratory chain. In vitro cell studies have shown that rotenone-induced toxicity is reduced by the use of N-acetylcysteine, antioxidants and potassium channel openers. However, no animal studies have been reported that confirm these findings, and there are no previous reports of attempted use of these agents in patients with acute rotenone-induced toxicity.
Rapidly Growing Pancreatic Adenocarcinoma Presenting as an Irreducible Umbilical Hernia
Authors: Deepti M Reddi, Kathryn P Scherpelz, Angelica Lerma, Jabi Shriki, Jeffrey Virgin
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Hernia sacs are a common anatomic pathology specimen, which rarely contain malignancy. We present a case of rapidly growing pancreatic adenocarcinoma, which initially presented as metastasis to an umbilical hernia sac. The patient was a 55-year-old male with a two-year history of umbilical hernia. Two months prior to herniorrhaphy, the hernia became painful and the patient experienced nausea and weight loss. The gross examination did not reveal distinct lesions. Microscopically, the hernia sac was diffusely infiltrated by moderately differentiated adenocarcinoma, which was positive for CK7 and pancytokeratin and negative for TTF-1, CK20, PSA, and CDX2. Clinical laboratory tests found elevated levels of CA 19-9 and CEA. Computed tomography scan with intravenous contrast showed a 5 cm ill-defined and hypoattenuating mass involving the pancreatic tail and body, as well as numerous ill-defined lesions in the liver and peritoneal carcinomatosis. The patient had an earlier noncontrast computed tomography scan four months prior to the surgery, which did not detect any lesions in the abdomen. This case highlights the importance of intravenous contrast with computed tomography for the evaluation of pancreatic lesions and also emphasizes the importance of thorough histologic evaluation of hernia sacs for the detection of occult malignancy.
Expectant Management of a Critically Ill Pregnant Patient with COVID-19 with Good Maternal and Neonatal Outcomes
Authors: Farah Alsayyed, Victoria Hastings, Sanford Lederman
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Background:
Coronavirus Disease 2019 (COVID-19) is responsible for a global pandemic that has significantly affected New York City. There is limited data about COVID-19 infection in pregnancy, especially in critically ill patients.
Case:
A 30-year-old female who presented at 26 weeks gestation with acute severe respiratory distress that required intubation and intensive care unit (ICU) admission. We had a high suspicion of COVID-19 disease despite repeated negative SARS-CoV-2 PCR testing, with eventual positive COVID IgG antibody testing. Through an integration of obstetrical knowledge, critical care, and comparing outcomes from similar cases in the literature, we decided to expectantly manage her pregnancy and did not recommend administration of antenatal steroids. She was extubated after 23 days of mechanical ventilation and recovered from her respiratory illness. She had a full-term spontaneous vaginal delivery of a baby boy at 39 weeks gestation with excellent maternal and fetal outcomes at delivery.
Conclusion:
In the face of COVID-19, a new disease with unclear maternal and fetal outcomes to date, a collaboration of care teams is essential to navigate through the challenging decisions made, including timing of delivery, treatment options, and administration of steroids. Our paper is unique as there is no other published case report of a critically ill pregnant patient with COVID-19 in which delivery was deferred, and a full recovery was observed, with a vaginal delivery at term.
A huge adenomatoid odontogenic tumor of maxilla
Authors: Balasundari Shreedhar, Iqbal Ali, Anshita Agarwal, Sarwar Alam
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

The adenomatoid odontogenic tumor (AOT) is a benign, nonneoplastic (hamartomatous) lesion with a slow progressing growth. It occurs in both intraosseous and peripheral forms. This paper reports the case of a female aged 16 years who presented with a swelling in anterior maxilla; canine was missing, and a supernumerary tooth was present in the mid line. Radiology revealed a well-defined radiolucent area associated with impacted canine and root resorption of adjacent teeth, which was diagnosed histopathologically as AOT. The patient was treated surgically and later rehabilitated with fixed prosthesis.
Case Report: Immune checkpoint inhibitor-related vitiligo-like depigmentation in non-melanoma advanced cancer: A report of three cases and a pooled analysis of individual patient data
Authors: Hui Rao, Zheng Guo, Xuejiao Wen, Xiaoli Zeng, Longqiu Wu, Li Huang
Journal: Front Oncol (2023)
Keywords: case report, immune checkpoint inhibitor, immunotherapy, skin adverse events, vitiligo-like depigmentation
MeSH terms: Case Reports

Background:
Vitiligo-like depigmentation is a common skin adverse event in patients receiving immunotherapy for malignant melanoma, but has been rarely reported in patients with non-melanoma malignancies. To better understand this immune-related adverse event, we reviewed a series of cases of immunotherapy induced vitiligo-like depigmentation in patients with cancers other than malignant melanoma.
Case presentation:
We report three cases of vitiligo-like depigmentation after immune checkpoint inhibitor treatment in gastric adenocarcinoma, lung adenocarcinoma, and squamous cell carcinoma. The first case was treated with camrelizumab, the second was treated with QL1706 injection and sintilimab, and the third was treated with tislelizumab. Pembrolizumab, nivolumab, and ipilimumab caused the majority of vitiligo-like depigmentation, and all three of our patients experienced similar vitiligo-like depigmentation after taking other immune checkpoint inhibitors.
Methods:
Three patients who presented with vitiligo-like depigmentation after treatment with immune checkpoint inhibitors were selected. The clinical features, including radiological and histological examination, and the treatment process were reviewed. Eighteen previously published cases of vitiligo-like depigmentation were also used to analyze the results. The severity of vitiligo-like depigmentation in these cases was graded according to the Common Terminology Criteria for Adverse Events, version 5.0.
Results:
Vitiligo-like depigmentation occurred in 13 men (61.90%) and 8 women (38.10%), aged from 46 to 79 years, with an average age of 69.9 years. Of the 21 reviewed cases, vitiligo-like depigmentation was described in lung cancer (13/21, 61.90%), clear cell renal cell carcinoma (2/21, 9.52%), acute myeloid leukemia (1/21, 4.76%), cholangiocarcinoma (1/21, 4.76%), urothelial carcinoma (1/21, 4.76%), oral squamous cell carcinoma (1/21, 4.76%), esophageal squamous cell carcinoma (1/21, 4.76%), and gastric adenocarcinoma (1/21, 4.76%). The severity of vitiligo-like depigmentation after immunotherapy was unrelated to sex, age, cancer type, previous autoimmune diseases, and medication.
Conclusions:
Vitiligo-like depigmentation is a non-specific skin adverse event in melanoma immunotherapy, but arises as a direct result of treatment with immune checkpoint inhibitors. Vitiligo-like depigmentation has an irregular location, is not limited to direct sunlight cracks, and has also been reported on hair on the head, eyelashes, and eyebrows. People without any skin or autoimmune diseases can also experience vitiligo-like depigmentation after immunotherapy; the incidence of which is irrespective of sex, age, cancer type, previous autoimmune diseases, and medication.
Second lung malignancy and Richter syndrome in chronic lymphocytic leukemia: case report and literature review
Authors: Ghassen Soussi, Selsabil Daboussi, Samira Mhamdi, Zied Moatemri, Hela Ghedira, Chiraz Aichaouia, Mohsen Khadhraoui, Faouzi El Mezni, Rezaik Cheikh
Journal: Multidiscip Respir Med (2017)
Keywords: b cell lymphoma, chronic lymphocytic leukemia, lung cancer, lymphadenopathy, richter syndrome, second lung malignancy
MeSH terms: Case Reports

Background:
Chronic lymphocytic leukemia (CLL) is the most frequent lymphoproliferative disease. Transformation into Richter disease and occurrence of second malignancies involving the lungs are rare complications. The hallmarks of any thoracic involvement are still unknown.
Case presentation:
We report a case of a 56-year-old male patient, with history of tobacco smoking, who presented with recurrent hemoptysis, fatigue and weight loss. Physical examination was normal except a slightly enlarged supraclavicular lymph node. Chest x-ray revealed a mediastinal widening due to enlarged paratracheal nodes and a left parahilar infiltrate. Blood tests showed a hyperlymphocytosis and a biological inflammatory syndrome. CT scan showed bilateral mediastinal and axillary lymphadenopathy, as well as left supraclavicular lymphadenopathy, with a left upper lobe alveolar attenuation and a solitary contralateral pulmonary nodule. Examination of Virchow's node and bone marrow biopsies confirmed metastasis of a pulmonary adenocarcinoma, as well as chronic lymphocytic leukemia with Richter's transformation. The clinical course was unfavorable since the first days of therapy as the patient passed away in a matter of a few days.
Conclusions:
Steady surveillance of CLL patients and systematic screening for second solid tumors, particularly lung cancer, and Richter's transformation seem to be relevant more than ever. Early diagnosis might help us understand the pathways leading to these complications and adapt therapy.
Organoaxial gastric volvulus: a rare cause of an acute abdomen
Authors: Katrin Bauer, Christof Keller
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2019)
Keywords: epigastric pain, gastric volvulus, upper-gi-obstruction, vomiting
MeSH terms: Case Reports

We report the case of a 65-year-old male patient with massive epigastric pain of sudden onset and vomiting due to an organoaxial volvulus of the stomach. We comment on the surgical management in our case and discuss etiology and therapeutic options of this rare entity.
Cardiac Excrescences of Unusual Origin
Authors: Jason R Stuck, Amgad N Makaryus
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) are a rare finding that are most often discovered incidentally either upon echocardiography or invasive cardiovascular procedures. In total, less than 50 known cases have been reported since first being discovered over 30 years ago. They are typically benign lesions; however, there has been a reported case of cardiac MICE being responsible for severe cardiopulmonary compromise and another case of the lesion embolizing leading to cerebral infarctions and ultimately death. Cardiac papillary fibroelastomas are also uncommon lesions found in the heart though they are not as rare as cardiac MICE. They are also benign and are typically attached to valvular surfaces; however, they also can be found as mobile masses. Just as cardiac MICE, they are capable of causing turbulent flow and thrombus formation and have been reported as the cause of ischemic events due to their ability to embolize. We present a case of cardiac MICE and cardiac papillary fibroelastoma in an individual who initially presented with neurologic symptoms concerning for a cerebrovascular accident. The patient was found to have a left ventricular mass composed of both cardiac MICE and cardiac papillary fibroelastomas.
Splenocolic fistula in a patient with diffuse large B-cell lymphoma: A case report and review of literature
Authors: Tonia Luca, Mauro Sergi, Onella Coco, Emanuela Leone, Giulia Chisari, Paolo Fontana, Sergio Castorina
Journal: Front Surg (2022)
Keywords: atypical presentation, diffuse large b-cell lymphoma, fistula, lymphoma diagnosis, splenomegaly
MeSH terms: Case Reports

A fistula that connects the bowel to other organs, such as the urinary bladder or small intestine, is a relatively frequent complication, often associated with inflammatory diseases such as diverticulitis, Crohn's disease, colorectal cancer, or lymphoma. Splenocolic fistula is an extremely rare condition described in the literature. It can occur in cases of splenic tumors, including splenic diffuse large B cell lymphoma. We report the case of an 82-year-old man who presented with melaena, worsening asthenia, hypotension, and abdominal pain in the left flank and the ipsilateral lumbar region. Ultrasound and computed tomography documented splenomegaly, thickening of the splenic flexure of the colon, and the presence of a fistulous passage between the colon and the splenic hilum. The diagnosis of lymphoma was made following laparotomy and caudal splenopancreatectomy. Due to the aggressive clinical behavior of this type of lymphoma, splenectomy is the main treatment in patients with splenomegaly, abdominal pain, and tumor expansion.
Bilateral Intra-Articular Radiofrequency Ablation for Cervicogenic Headache
Authors: Charles A Odonkor, Teresa Tang, David Taftian, Akhil Chhatre
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Introduction. Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. It remains unclear whether targeting this joint has potential for symptomatic relief. To address this issue, we present a case report of C1-2 joint ablation with positive outcomes. Case Presentation. A 27-year-old female presented with worsening cervicogenic headache. Her pain was 9/10 by visual analog scale (VAS) and described as cramping and aching. Pain was localized suboccipitally with radiation to her jaw and posterior neck, worse on the right. Associated symptoms included clicking of her temporomandibular joint, neck stiffness, bilateral headaches with periorbital pain, numbness, and tingling. History, physical exam, and diagnostic studies indicated localization to the C1-2 joint with 80% decrease in pain after C1-2 diagnostic blocks. She underwent bilateral intra-articular radiofrequency ablation of the C1-C2 joint. Follow-up at 2, 4, 8, and 12 weeks showed improved function and pain relief with peak results at 12 weeks. Conclusion. Clinicians may consider C1-C2 joint ablation as a viable long-term treatment option for cervicogenic headaches.
Acute Fatty Liver Disease of Pregnancy in the Second Trimester
Authors: Faraz Afridi, Michael Feely, Raju Reddy
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Acute fatty liver of pregnancy (AFLP) is a rare disorder that typically presents in the third trimester. We report a case of a 21-year-old woman with a history of intrauterine fetal demise at 19 weeks' gestation who developed fulminant liver failure 1 week after the fetal demise. She was diagnosed with AFLP as per the Swansea criteria. An orthotopic liver transplant was attempted but was unsuccessful. AFLP usually presents between the 30th to 38th weeks of gestation. However, it can occur in the postpartum period after only 19 weeks of gestation as highlighted in our case.
Abdominal Mass Secondary to Human Toxocariasis
Authors: Javad Ghoroobi, Leily Mohajerzadeh, Maliheh Khoddami, Alireza Mirshemirani, Naser Sadeghian, Alireza Mahdavi, Sayeh Hatefi
Journal: APSP J Case Rep (2017)
Keywords: abdominal mass, human, toxocariasis
MeSH terms: Case Reports

Toxocariasis is an extensive helminthic infection that leads to visceral larva migrans in humans. A 2.5-year-old girl referred for abdominal mass. She had history of pharyngitis for two weeks. There were no other symptoms. Abdominal examination revealed an irregular solid mass in right lower quadrant (RLQ). Abdominal ultrasonography revealed an echohetrogenic large mass in RLQ, liver, and retroperitoneal area. Abdominal CT scan showed a huge mass. At laparotomy a large retroperitoneal mass that involved right liver lobe, bladder, ileocecal valve, small and large intestines was found. At histopathology diagnosis of toxocariasis was made.
Occult follicular thyroid carcinoma presenting as a frontal bone metastasis: a case report
Authors: Mahmoudreza Tahamtan, Maral Mokhtari, Sara Pakbaz, Mehdi Tahamtan
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

This is a rare case of metastatic follicular carcinoma of thyroid in a patient with no history of thyroid problem. A frontal bone mass was examined microscopically and showed the pattern of metastatic follicular carcinoma. Thyroid ultrasonography then revealed a nodule in left lobe. Total thyroidectomy was done for the patient and microscopic examination confirmed the diagnosis.
Pulmonary nodules associated with JAK inhibitor therapy in rheumatoid arthritis: A case report
Authors: N Pannell, D Joseph, M M T M Ally, N M Bida, G R Tintinger
Journal: Afr J Thorac Crit Care Med (2021)
Keywords: janus kinase inhibitors, opportunistic infections
MeSH terms: Case Reports

Patients with rheumatoid arthritis (RA) may receive Janus kinase (JAK) inhibitors to achieve optimal control of their disease. We report a case of a patient who received a selective JAK1 inhibitor and subsequently developed multiple pulmonary nodules with cavitation. Biopsies confirmed the presence of cryptococcosis and the patient responded well to anti-fungal therapy.