OpenMed/multicare-articles huggingface dataset:
Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients
Authors: Feng Gao, Jianguo Li, Shengwei Quan, Fujun Li, Donglai Ma, Lei Yao, Ping Zhang
Journal: Biomed Res Int (2016)
MeSH terms: Hemorrhage / etiology, Hemorrhage / therapy, Pancreaticoduodenectomy / adverse effects, Adult, Aged, Female, Hemorrhage / epidemiology, Humans, Male, Middle Aged, Multivariate Analysis, Pancreaticoduodenectomy / mortality, Postoperative Complications / etiology, Risk Factors, Young Adult

The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785-25.792; P = 0.005), history of abdominal surgery (OR = 5.009; 95% CI: 1.968-12.749; P = 0.001), and preoperative albumin levels (OR = 4.863; 95% CI: 1.962-12.005; P = 0.001). Independent risk factors of late PPH included postoperative pancreatic leakage (OR = 4.696; 95% CI: 1.605-13.740; P = 0.005), postoperative biliary fistula (OR = 6.096; 95% CI: 1.575-23.598; P = 0.009), postoperative abdominal infection (OR = 4.605; 95% CI: 1.108-19.144; P = 0.036), revascularization (OR = 9.943; 95% CI: 1.900-52.042; P = 0.007), history of abdominal surgery (OR = 8.790; 95% CI: 2.779-27.806; P < 0.001), and preoperative albumin levels (OR = 5.563; 95% CI: 1.845-16.776; P = 0.002).
Removal of a Tungsten Carbide Ring from the Finger of a Pregnant Patient: A Case Report Involving 2 Emergency Departments and the Internet
Authors: Alexandre Moser, Aristomenis Exadaktylos, Alexander Radke
Journal: Case Rep Emerg Med (2016)

Introduction. Destructive or nondestructive procedures may be used to remove rings from injured fingers. Because of their hardness, tungsten carbide rings present special problems. Case Presentation. The patient was a 33-year-old woman, two weeks before delivery, with a swollen and reddened ring finger. It was decided to remove a tungsten carbide ring from her ring finger. This was achieved by shattering the ring with locking pliers. The patient's ring finger recovered fully.
Skin involvement in primary systemic amyloidosis
Authors: Susheel Kumar, Rimi Som Sengupta, Nandita Kakkar, Aman Sharma, Surjit Singh, Subhash Varma
Journal: Mediterr J Hematol Infect Dis (2013)
MeSH terms: Case Reports

Primary systemic amyloidosis is a rare disease. It primarily involves kidney, heart, peripheral nerves and liver. Intracutaneous hemorrhage manifesting in the form of petechiae, purpura and ecchymoses due to infiltration of blood vessel walls by amyloid deposits are the most common skin lesions. We report a case of primary systemic amyloidosis with multiple, non-itchy, papular lesions in lower eyelids and lower chest wall bilaterally. Diagnosis was confirmed in this case by biopsy of skin lesions using congo red staining. Papular eruptions as seen in index patient are relatively uncommon form of skin manifestations.
Importance of the Wrist Extensor Muscle Training: Two Cases of Elbow Flexorplasty following Traumatic Brachial Plexus Injuries
Authors: Shigeki Kubota, Tadashi Kubo, Hiromi Kameda, Yoshiyasu Itoh
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

The modified Steindler procedure-a reconstructive surgery used to restore elbow flexion following upper brachial plexus injuries-involves shifting the origins of the muscle groups responsible for wrist flexion and forearm pronation originating from the medial epicondyle to the proximal direction to be used as flexors of the elbow. In the postoperative rehabilitation, we focused on strengthening not only the transferred muscle but also the wrist extensor muscles as antagonist muscles. After reconstruction surgery for elbow flexion via the modified Steindler procedure for traumatic brachial plexus injury, we performed long-term rehabilitation to strengthen the antagonist muscles. As a result, in two cases, excellent elbow flexion strength and gripping strength were achieved, confirming the importance of the antagonist muscles.
Soft-tissue metastasis revealing a pancreatic adenocarcinoma: one case report and a review of literature
Authors: Yousra Akasbi, Samia Arifi, Mohammed El Idrissi, Mohammed Shimi, Faouzi Boutayeb, Abdelmjid El Mrini, Omar El Mesbahi
Journal: Pan Afr Med J (2012)
Keywords: morocco, soft tissue metastases, computer tomography scan, pancreatic adenocarcinoma, rare
MeSH terms: Adenocarcinoma / diagnosis, Adenocarcinoma / pathology, Pancreatic Neoplasms / diagnosis, Pancreatic Neoplasms / pathology, Soft Tissue Neoplasms / diagnosis, Soft Tissue Neoplasms / secondary, Case Reports, Review, Adenocarcinoma / drug therapy, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Buttocks, Deoxycytidine / administration & dosage, Deoxycytidine / analogs & derivatives, Diagnosis, Differential, Female, Gemcitabine, Humans, Middle Aged, Pancreatic Neoplasms / drug therapy, Soft Tissue Neoplasms / drug therapy, Thigh, Deoxycytidine, Gemcitabine

Soft tissue metastases from pancreatic adenocarcinoma are rare lesions and can be the source of diagnostic confusion both clinically and pathologically. To our knowledge, one patient has been reported on with soft tissue lesions that ultimately disclose a pancreatic adenocarcinoma. We report here on a patient who presented with a metastatic soft tissue lesion in the trochanter, and the buttocks, as the initial manifestation of pancreatic adenocarcinoma. Soft tissue metastasis from pancreatic carcinoma is a rare finding. Clinicians should be aware that metastatic soft tissue lesions could be the initial presenting sign for pancreatic cancer. Also, the immunohistochemical staining for CK 7 and 19 may be helpful for the diagnosis of metastatic pancreatic adenocarcinoma.
Intramedullary Teratoma of Spine in an Adult Patient
Authors: Suryansh Arora, Shishir Chumber, Kavita Vani
Journal: J Belg Soc Radiol (2022)
Keywords: mri, adult, spinal teratoma
MeSH terms: Case Reports

Spinal teratomas are rare spinal tumors. Most of these present in children. We present the imaging findings of a spinal teratoma that was not symptomatic until adulthood. Teaching point: Congenital spinal tumors may occasionally present for the first time in adulthood, and radiologists need to be familiar with the imaging findings.
Conservative treatment of a patient with epidermolysis bullosa presenting as bart syndrome: a case report
Authors: Samet Vasfi Kuvat, Mehmet Bozkurt
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

We presented a case of a newborn male with aplasia cutis congenita on the lower limb. The case was treated with conservative method. As for the conservative treatment, daily hydrodebridement with 1/200 diluted povidone-iodine and serum physiologic was performed, followed by closure of the wound with a dexpanthenol + chlorhexidine + fusidic acid-impregnated sterile gauze bandage. the followup that occured after three weeks, the wound was completely epithelialized, but a hypopigmented scar remained in the limb.
Neuroblastoma presenting like a Wilms' tumor with thrombus in inferior vena cava and pulmonary metastases: a case series
Authors: Genevieve Gaetan, Alain Ouimet, Chantale Lapierre, Pierre Teira, Herve Sartelet
Journal: Springerplus (2014)
Keywords: neuroblastoma, pulmonary metastases, thrombus in inferior vena cava, wilms’ tumor

Neuroblastomas and Wilms' tumors are frequent pediatric solid tumors. The first is frequently detected in the adrenal gland and the second develops in the kidneys. The extension through the vena cava and the lung metastases are frequent in Wilms' tumors and are rarely seen in neuroblastoma. We present the cases of three children with abdominal tumors with thrombus in the inferior vena cava and pulmonary metastases demonstrating a stage 4 neuroblastoma. The three male patients were between 23 to 48 months old. They presented an abdominal mass, near the superior pole of the kidney. Thrombus of the vena cava was showed on imaging studies in all cases and pulmonary metastases were always found. Catecholamine metabolites were present in the first case and negative in the two others. Two out of three patients had a radical nephrectomy. The pathological analysis always found a poorly differentiated or undifferentiated neuroblastoma without MYCN amplification and confirmed the vein tumoral thrombus in the second case. The evolution of the first two patients was unfavorable and the third is alive. Invasion of the inferior vena cava and pulmonary metastases in children with neuroblastoma is uncommon and can modify the surgical management.
Hoffmann syndrome: a case report
Authors: Hemal Ms Senanayake, Anujaya D Dedigama, Randil P De Alwis, Kanapathipillai Thirumavalavan
Journal: Int Arch Med (2014)
MeSH terms: Case Reports

Hoffmann syndrome is a rare form of hypothyroid myopathy in adults characterized by presence of muscle weakness, stiffness and pseudohypertrophy. We report a 39 year old male with primary hypothyroidism diagnosed at childhood and not on regular thyroxine therapy who presented with fatigue, cold intolerance, constipation, exertional breathlessness, progressive proximal muscle weakness and swelling of the legs for one year. Examination revealed pseudohypertrophy of calf muscles with marked symmetrical proximal upper and lower limb weakness. His TSH and Creatine phosphokinase (CPK) levels were significantly elevated and electromyography (EMG) was compatible with myopathic disorder. After institution of thyroxine therapy his weakness improved markedly and pseudohypertrophy regressed in two months. We report this case because of its rarity.
Not Hot, but Sharp: Dissociation of Pinprick and Heat Perception in Snake Eye Appearance Myelopathy
Authors: Jan Rosner, Michèle Hubli, Pascal Hostettler, Catherine R Jutzeler, John L K Kramer, Armin Curt
Journal: Front Neurol (2018)
Keywords: cervical myelopathy, clinical neurophysiology, contact heat evoked potentials (cheps), pinprick evoked potentials (peps), snake eye myelopathy, spinothalamic tract
MeSH terms: Case Reports

Following a traumatic spinal cord injury, a 53-year-old male developed a central cord syndrome with at-level neuropathic pain. Magnetic resonance imaging revealed a classical "snake eye" appearance myelopathy, with marked hyperintensities at C5-C7. Clinical examination revealed intact pinprick sensation coupled with lost or diminished thermal/heat sensation. This dissociation could be objectively confirmed through multi-modal neurophysiological assessments. Specifically, contact heat evoked potentials were lost at-level, while pinprick evoked potentials were preserved. This pattern corresponds with that seen after surgical commissural myelotomy. To our knowledge, this is the first time such a dissociation has been objectively documented, highlighting the diagnostic potential of multi-modal neurophysiological assessments. In future studies, a comprehensive assessment of different nociceptive modalities may help elucidate the pathophysiology of neuropathic pain.
Efficacy of the Combination of rhBMP-2 with Bone Marrow Aspirate Concentrate in Mandibular Defect Reconstruction after a Pindborg Tumor Resection
Authors: Kamel Alraei, Jameel Sharqawi, Somaya Harcher, Ibrahim Ghita
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive growth factor used in oral and maxillofacial surgery. It offers a feasible alternative for various regenerative procedures, including reconstruction of mandibular defects. In this study, we report a case of a large Pindborg tumor involving the left mandible. The treatment consisted of surgical resection, followed by off-label use of rhBMP-2 in addition to bone marrow aspirate concentrate, together with an allograft in a titanium mesh. The patient was rehabilitated with dental implants, and a good clinical outcome was achieved. We found no evidence of bone resorption or complications in both clinical and radiographic evaluations during the one-year follow-up period. In conclusion, we have demonstrated the efficacy of using rhBMP-2 combined with bone marrow aspirate concentrate, and an allograft with a titanium mesh, for the reconstruction of long mandibular bone defects. Not only is this combination feasible, but it also has the advantages of lower morbidity and cost.
Esophageal Stricture Caused by Actinomyces in a Patient with No Apparent Predisposing Factors
Authors: Allison N Zhang, Debra Guss, Smruti R Mohanty
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Actinomyces species are Gram positive anaerobic or microaerophilic bacteria that are part of the human flora in the oropharyngeal, gastrointestinal, and genitourinary tract. In the presence of a mucosal injury, they can become pathogenic and infect the underlying tissue without respect for tissue planes, leading to abscesses, fistulas, and sinus tracts. Through contiguous and hematogenous spread, virtually any organ can become infected. The presentation can be myriad and often mimics tumors, tuberculosis, or other more common infections and inflammatory conditions. While the cervicofacial region is the most common site of infection, involvement of the esophagus is unusual. Esophageal actinomycosis mostly occurs in patients with compromised immunity or prior esophageal injuries. Occurrence in immunocompetent individuals without risk factors is exceedingly rare. We report a case of esophageal actinomycosis complicated by an esophageal stricture in a patient with no apparent predisposing conditions.
Rotational Atherectomy-Assisted Crossing of a Complex Right Coronary Artery Lesion Using the Retrograde Approach
Authors: Abdul-Subulr Yakubu, Xiaoqiang Zhang, Bin Zhang
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Chronic total occlusion lesions present a major challenge for the interventional cardiologist. In this case, we report the successful use of rotational atherectomy to facilitate retrograde percutaneous coronary intervention of a complex totally occluded right coronary artery after modification of the proximal cap of the lesion to enable placement of the RotaWire in the vessel architecture.
Case Report: SMART ANTON: Anton-Babinski Syndrome in Stroke-Like Migraine Attacks (SMART) After Radiation Therapy: Two Rare Syndromes, One Case
Authors: Nicolas Nagysomkuti Mertse, René Müri
Journal: Front Neurol (2022)
Keywords: anton-babinski syndrome, riddoch syndrome, smart syndrome, cortical blindness, dual etiology, visual associative agnosia
MeSH terms: Case Reports

Introduction:
We describe the case of a 57-years-old patient who presented an Anton-Babinski syndrome in the context of a stroke-like migraine attack after radiation therapy (SMART).
Case report:
The patient was brought to the emergency room following a sudden loss of vision in the context of a pre-existing left-sided hemianopia after excision of a right occipital astrocytoma followed by radio-chemotherapy 35 years prior to his admission in our services. At admittance, he also presented hyperthermia, hypertension, and a GCS of 7. The MRI showed a leptomeningeal enhancement in the left temporal, parietal, and occipital lobes. After exclusion of other differential diagnoses, we diagnosed a cortical blindness in the context of a SMART syndrome affecting the left hemisphere. While the symptoms improved under corticosteroid therapy, the patient successively presented an Anton-Babinski syndrome, a Riddoch syndrome and a visual associative agnosia before finally regaining his usual sight.
Discussion:
This is, to our knowledge, the first report of an Anton-Babinski syndrome in the context of a SMART syndrome. A dual etiology is mandatory for cortical blindness in SMART syndrome since the latter affects only one hemisphere. A SMART syndrome affecting the contralateral hemisphere in respect to the radiation site seems to be uncommon, which makes this case even more exceptional.
Aggressive Systemic Mastocytosis in Association with Pure Red Cell Aplasia
Authors: Dhauna Karam, Sean Swiatkowski, Mamata Ravipati, Bharat Agrawal
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Aggressive systemic mastocytosis (ASM) is characterized by mast cell accumulation in systemic organs. Though ASM may be associated with other hematological disorders, the association with pure red cell aplasia (PRCA) is rare and has not been reported. Pure red cell aplasia (PRCA) is a syndrome, characterized by normochromic normocytic anemia, reticulocytopenia, and severe erythroid hypoplasia. The myeloid and megakaryocytic cell lines usually remain normal. Here, we report an unusual case of ASM, presenting in association with PRCA and the management challenges.
Severe Allergic Bronchopulmonary Mycosis and Long-Term Follow-Up
Authors: Hossein Esmaeilzadeh, Sara Kashef, Hamid Reza Hatami, Soheila Alyasin, Hesamodin Nabavizadeh, Elmira Esmaeilzadeh
Journal: Case Reports Immunol (2018)
MeSH terms: Case Reports

Allergic bronchopulmonary aspergillosis (ABPA) is the most common immunologic reaction following fungal allergen exposure in asthmatic patients. A less frequent syndrome in response to other fungal species like candida is allergic bronchopulmonary mycosis (ABPM). This reaction is mostly associated with asthma exacerbation, changes in Immunoglobulin E levels, and nonspecific findings in high resolution computed tomography (HRCT). This study presents a 9-year-old girl, a known case of childhood asthma, resolved 4 years ago as a novel case of ABPM due to Candida albicans manifested by severe emphysema, bronchiectasis, and pneumothorax which consequently required long-term treatment to get relieved.
Positive response to niraparib in chemo-refractory patients with metastatic appendiceal mucinous adenocarcinoma harboring ATM mutations: A case report
Authors: Junhui Wang, Huijuan He, Wansu Xu, Jianxin Chen
Journal: Front Oncol (2023)
Keywords: appendiceal mucinous adenocarcinoma, ataxia-telangiectasia mutated (atm), chemo-refractory, homologous recombination deficiency, niraparib
MeSH terms: Case Reports

Background:
Appendiceal mucinous adenocarcinoma, one kind of specific colorectal cancer, is lowly prevalent and rarely diagnosed in clinical practice. In addition, there have been limited standard treatment strategies established for patients with appendiceal mucinous adenocarcinoma, especially with metastatic disease. The regimens for colorectal cancer, which were adopted in appendiceal mucinous adenocarcinoma, usually resulted in limited effectiveness.
Case presentation:
Herein, we presented a case of chemo-refractory patient with metastatic appendiceal mucinous adenocarcinoma harboring ATM pathological mutation of exon 60, c.8734del, p.R2912Efs*26, and who has achieved a persistent response to salvage treatment of niraparib, with disease control time that reached 17 months and still in extension.
Conclusions:
We supposed that appendiceal mucinous adenocarcinoma patients harboring ATM pathological mutations may respond to the treatment of niraparib, even without a homologous recombination deficiency (HRD) status; however, it needs further confirmation in a larger cohort.
Spontaneous hepatic rupture during late pregnancy in a patient with solitary necrotic nodule of the liver: A case report
Authors: Jilong Wang, Qilin Yi, Ya Guo, Tao Peng
Journal: Front Med (Lausanne) (2022)
Keywords: case report, multidisciplinary collaboration, pregnancy, solitary necrotic nodule of the liver, spontaneous hepatic rupture
MeSH terms: Case Reports

Background:
Spontaneous hepatic rupture (SHR) during pregnancy is a rare and life-threatening event, which usually occurs together with preeclampsia, eclampsia, HELLP syndrome, or liver tumors. However, SHR resulting from solitary necrotic nodule of the liver (SNNL) is extremely rare.
Case presentation:
We report the case of a 32-year-old pregnant woman who presented at 33 weeks of gestation with abdominal pain and emesis. Transabdominal ultrasound and magnetic resonance imaging revealed massive hemoperitoneum and lesions in the left lobe of the liver. An emergency cesarean section was performed and the hepatic rupture was managed surgically via left lateral lobectomy. The postprocedural course was uneventful. The premature baby successfully survived, and the patient was discharged 8 days after admission without complications. Histological examination revealed a diagnosis of SNNL, which resulted in the hepatic hematoma and SHR.
Conclusion:
To our knowledge, this is the first case of SHR resulting from SNNL during late pregnancy. Multidisciplinary collaboration and surgical management are important cornerstones for improving the perinatal outcomes when SHR is suspected in a pregnant patient.
About a rare disease misdiagnosed as malignant lymphoma or tuberculosis: Kikuchi-Fujimoto's disease
Authors: Jawad Lahma, Zakaria Arkoubi, Reda Hejjouji, Sophia Nitassi, Ali El Ayoubi, Razika Bencheikh, Mohammed Anas Benbouzid, Abdelilah Oujilal, Leila Essakalli
Journal: Pan Afr Med J (2018)
Keywords: kikuchi-fujimoto disease, lymphadenopathy, necrotizing histiocytic lymphadenitis
MeSH terms: Histiocytic Necrotizing Lymphadenitis / diagnosis, Lymphoma / diagnosis, Tuberculosis / diagnosis, Case Reports, Adrenal Cortex Hormones / administration & dosage, Adult, Biopsy, Diagnosis, Differential, Diagnostic Errors, Female, Fever / etiology, Histiocytic Necrotizing Lymphadenitis / drug therapy, Histiocytic Necrotizing Lymphadenitis / pathology, Humans, Rare Diseases / diagnosis, Rare Diseases / drug therapy, Rare Diseases / pathology, Adrenal Cortex Hormones

Kikuchi-Fujimoto's disease KFD is a rare and benign cause of cervical lymphadenopathy. It is an anatomoclinical entity of unknown etiology. The confirmation of the diagnosis is always provided by histological lymph node study. The clinical picture sometimes evokes lymphoma or tuberculosis. The evolution is generally favorable with spontaneous healing after a few weeks. We report the case of a 26-year-old woman who had consulted for cervical lymphadenopathy associated with fever. The cervical lymph node biopsy concluded to Kikuch-Fujimoto's disease. The evolution was marked by rapid regression of lymphadenopathy under corticosteroid treatment.