OpenMed/multicare-articles huggingface dataset:
Implant-Prosthetic Rehabilitation in Bilateral Agenesis of Maxillary Lateral Incisors with a Mini Split Crest
Authors: M M Figliuzzi, A Giudice, S Pileggi, D Pacifico, M Marrelli, M Tatullo, L Fortunato
Journal: Case Rep Dent (2016)

The reported clinical case describes the surgical procedure of ridge augmentation by using a "split crest" technique with a partial thickness flap and a subsequent implant-prosthetic rehabilitation aimed at treating a bilateral agenesis of the upper lateral incisors. In such cases with vestibule-palatal and mesial-distal scarce bone thicknesses associated with the need of a proper functional and aesthetic rehabilitation, the split crest technique is particularly suitable. In the case we reported, because of the poor bone thicknesses, we performed a minimally invasive split crest which allowed a correct insertion of the fixtures. This technique allowed us to achieve an optimal functional and aesthetic rehabilitation; moreover, we obtained a good emergency profile, ensuring the vitality of the close teeth and ensuring a good primary stability and the following osseointegration of dental implants.
Diffuse Alveolar Hemorrhage Induced by Vaping
Authors: Michael Agustin, Michele Yamamoto, Felix Cabrera, Ricardo Eusebio
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

There has been a significant increase in electronic cigarette (e-cigarette) use since its introduction in 2007. Ironically, there remains very few published literature on the respiratory complications of e-cigarettes. The use of personalized vaporizers or commonly known as "vaping" has started to overtake standard e-cigarette. Its dynamic vaporizer customization makes it challenging to assess long-term health effects. Case reports on the pulmonary complications of e-cigarettes are limited to bronchiectasis, eosinophilic pneumonia, pleural effusion, and suspected hypersensitivity pneumonitis. Diffuse alveolar hemorrhage (DAH) is bleeding into the alveolar spaces of the lung secondary to disruption of the alveolar-capillary basement membrane. We report a case of young male presenting with subacute respiratory failure. He was later found to have diffuse alveolar hemorrhage syndrome that is likely induced by aggressive vaping. This adds up to the rising concern on the possible serious complications of this innovative technology designed as a safer alternative to traditional cigarettes.
Unusual Case of an Infant with Urinary Tract Infection Presenting as Cholestatic Jaundice
Authors: Rahaf Niazi, Bashaer Baharoon, Afnan Neyas, Meshari Alaifan, Osama Safdar
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

Neonatal jaundice is considered one of the most common reasons for admission to the pediatric medical ward. We report a case of a 1-month-old infant who presented with jaundice but no fever or any other signs of systemic illnesses. Laboratory test results revealed high direct hyperbilirubinemia, and urine culture showed a urinary tract infection with Enterobacter cloacae as the causative agent. He was admitted to the pediatric medical ward where he was treated with a course of antibiotics for 14 days, and cholestasis resolved completely following a course of antibiotics. We conclude that direct hyperbilirubinemia can be related to urinary tract infection in neonates. It is unusual for urinary tract infection to present clinically and biochemically as cholestatic jaundice.
Diffuse Subcutaneous Emphysema and Pneumomediastinum Secondary to a Minor Blunt Chest Trauma
Authors: Maximilian Andreas Storz, Eric P Heymann, Aristomenis K Exadaktylos
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall. Computed tomography (CT) demonstrated right-sided costal fractures (ribs 7 to 9), with diffuse subcutaneous emphysema and pneumomediastinum due to laceration of the visceral and parietal pleura and the adjacent lung parenchyma. In addition, a small ipsilateral pneumothorax was found. Surprisingly, the clinical status was only minimally affected by mild to moderate pain and minor functional impairment.
Surgical Treatment of a Rare Case of Ovarian Fibroma Associated With Elevated CA125 Levels in a Patient of Reproductive Age: A Case Report
Authors: Anna Thanasa, Efthymia Thanasa, Evangelos Kamaretsos, Ioannis Paraoulakis, Apostolos C Ziogas, Gerasimos Kontogeorgis, Vasiliki Grapsidi, Ektoras-Evangelos Gerokostas, Vasileios Kontochristos, Ioannis Thanasas
Journal: Cureus (2023)
Keywords: ca125, case report, diagnosis, magnetic resonance imaging, management, ovarian fibroma
MeSH terms: Case Reports

Small ovarian fibromas (< 10cm) associated with elevated serum CA125 levels are rarely encountered, particularly in women of reproductive age. We report a rare case diagnosed in a 35-year-old patient after adnexectomy for a solid ovarian mass of approximately 5cm in maximum diameter, accompanied by elevated serum CA125 levels. In preoperative evaluation, no signs of inflammation from the genital tract were found, and no medical history of endometriosis, uterine leiomyomas, or non-gynecological cancer was reported. Intraoperative frozen section biopsy of surgical specimen obtained from the ovarian tumor had negative evaluation for malignancy. Histological examination of the surgical specimen confirmed the diagnosis of ovarian fibroma. The postoperative course was uneventful. Two months after surgery, the blood serum CA125 levels were within normal ranges. The patient is assessed at regular intervals in the gynecology outpatient clinic. In this paper, based on the data of the modern literature, a brief review of this rare nosological entity is made.
Porphyria cutanea tarda with constrictive pericarditis: a rare association
Authors: Kaur Jasleen, Nidhi Sharma, Jyotika Kalsy, Mughda Sharma
Journal: Case Rep Dermatol Med (2012)
MeSH terms: Case Reports

Porphyria cutanea tarda(PCT) is characterised by photosensitivity and bulla formation on photoexposed parts which heals with scaring and pigmentation. PCT is frequently associated with diabetes mellitus, lupus erythematosus and hepetitis C virus infection. We are reporting and Indian patient of PCT associated with pericarditis which is very rare.
Pigmented free-floating posterior vitreous cyst
Authors: Claudia Bruè, Cesare Mariotti, Edoardo De Franco, Nicola De Franco, Alfonso Giovannini
Journal: Case Rep Ophthalmol Med (2012)

Vitreous cysts are very rare ocular malformations. In this observational case study, we report on an unusual case of a pigmented free-floating vitreous cyst and discuss its differential diagnosis. A 14-year-old male was referred to ophthalmology for a pigmented lesion in his left eye. He complained of an intermittent floater in the left eye. Visual acuity was 20/20 in the right eye and 20/40 in the left eye. Fundus examination was unremarkable bilaterally, except for a piece of brownish oval material floating in the vitreous in the left eye. He had received a knock on the left side of his head a few days before the visual discomfort of the left eye. Real-time ultrasound of the left eye detected a piece of hyperechogenic spherical material with no internal reflectivity, floating in the middle of the vitreous. The first use of color Doppler ultrasound in this context indicated no arterial flow, ruling out the presence of a persistent hyaloid artery. Intraocular cysts are rare ocular disorders, which have been divided into clear and pigmented cysts, and into those that occupy the anterior chamber, the retrolental space, and the vitreous cavity. This last is extremely rare. We describe such a case.
Obsessive-Compulsive Symptoms as a Manifestation of Homocystinuria
Authors: Vera Froes, Hugo Afonso, Zita Gameiro
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Homocystinuria is a rare autosomal recessive metabolic disorder due to a defect in the cystathionine β-synthase (CBS) that leads to high homocysteine plasma levels. Psychiatric symptoms secondary to homocystinuria have been described in the literature; however, there is a lack of information about obsessive-compulsive symptoms correlated to this disorder. We describe the case of a 39 years old man, diagnosed with homocystinuria in childhood, with no previous psychiatric history that presented obsessive-compulsive disorder (OCD) like symptoms, as a manifestation of homocystinuria. This case underlines the importance for a psychiatrist to explore medical nonpsychiatric history, especially when presentation is abrupt, atypical, or in treatment-resistant cases.
Dental Considerations in the Management of Glanzmann's Thrombasthenia
Authors: Diana N Mehta, Rupinder Bhatia
Journal: Int J Clin Pediatr Dent (2010)
Keywords: glanzmann’s thrombasthenia, pediatric dentist, platelet disorders, “acrylic-splint” appliance
MeSH terms: Case Reports

Glanzmann's thrombasthenia, is one of the rarest congenital, genetically inherited platelet disorder. It has an incidence of about 1:1,000,000, but is more common in populations with increased consanguinity. Glanzmann's thrombasthenia is characterized by deficiency or dysfunction of glycoprotein (GP) lib and Ilia, which are the receptors of fibrinogen. Both sexes are equally affected. Typical mucocutaneous bleeding occurs at birth or early infancy. Obtaining appropriate dental history of excessive bleeding after dental extraction, unexplained spontaneous mucocutaneous bleeding, gingival bleeding during teething or shedding of deciduous teeth and petechiae, ecchymoses or purpura on mucous membranes can play an important part in diagnosis. Hence, the pediatric dentist plays a very crucial role for prompt diagnosis and management of Glanzmann's thrombasthenia. Presenting here is a known case of Glanzmann's thrombasthenia, of a 6-year-old girl who required to undergo dental extraction and its successful management using an "acrylic-splint" along with the placement of "Calgigraf-Ag Foam".
Scimitar syndrome in an asymptomatic adult: fortuitous diagnosis by imaging technique
Authors: Miguel Angel Ramirez-Marrero, Manuel de Mora-Martin
Journal: Case Rep Vasc Med (2012)
MeSH terms: Case Reports

Congenital cardiopathies in adults are a rare clinical entity in the cardiology consultations. Advances in imaging techniques allow the fortuitous diagnosis of mild forms of these congenital abnormalities. We describe a case of an asymptomatic 41-year-old man, with a medical history of recurrent pneumonia during childhood and an established diagnosis of scimitar syndrome by computed tomography.
An Unexpected GIST Causing Life-Threatening Bleeding after an Elective Hernia Repair
Authors: Athary Saleem, Fatemah Husain, Reem Boushehry, Mohammed Alshamali, Emad Fahim, Khaleel Mohammad
Journal: Surg J (N Y) (2023)
Keywords: gist, case report, gastrointestinal stromal tumor, inguinal hernia, upper gi malignancy, wedge resection
MeSH terms: Case Reports

Background Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the alimentary tract. They are usually manifested by GI bleeding. Case Presentation A 53-year-old male patient was admitted to the hospital for elective inguinal hernia repair. The patient did not have any history of GI symptoms in the past. A day after open inguinal hernia repair, the patient developed recurrent attacks of hematemesis resulting in hemodynamic instability and admission to the intensive care unit. An upper GI endoscopy identified a small bleeding gastric lesion. After multiple failed attempts to control the bleeding endoscopically, an emergency exploratory laparotomy was performed. An unexpected large fungating bleeding gastric mass was detected. The mass measured approximately 40 × 30 cm, and multiple peritoneal deposits were also discovered. A wedge resection of the anterior gastric wall along with the mass was performed. Histopathology revealed a high-grade (G2) GIST. Discussion GISTs appear in variable sizes and may lead to a variety of complications including abdominal pain, GI obstruction, and bleeding. This case highlights the unexpected presentation and sudden bleeding of a large GIST in a totally asymptomatic patient undergoing elective hernia surgery. It also illustrates that GIST can be asymptomatic and grow to large sizes before developing clinical manifestations. Conclusion The case report highlights a common complication of GIST with unexpected timing, immediately after routine hernia surgery.
Gastric Cancer Is the Leading Cause of Death in Italian Adult Patients With Common Variable Immunodeficiency
Authors: Federica Pulvirenti, Antonio Pecoraro, Francesco Cinetto, Cinzia Milito, Michele Valente, Enrico Santangeli, Ludovica Crescenzi, Francesca Rizzo, Stefano Tabolli, Giuseppe Spadaro, Carlo Agostini, Isabella Quinti
Journal: Front Immunol (2018)
Keywords: iga, common variable immunodeficiency
MeSH terms: Common Variable Immunodeficiency / mortality, Endoscopy / methods, Helicobacter Infections / diagnosis, Stomach Neoplasms / epidemiology, Stomach Neoplasms / mortality, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Aged, 80 and over, Common Variable Immunodeficiency / epidemiology, Female, Gastritis, Atrophic / pathology, Helicobacter Infections / drug therapy, Helicobacter pylori / drug effects, Humans, Intestines / pathology, Italy / epidemiology, Longitudinal Studies, Lymphoma, Non-Hodgkin / epidemiology, Male, Middle Aged, Stomach Neoplasms / diagnosis, Young Adult

An increased prevalence of malignant lymphoma and of gastric cancer has been observed in large cohorts of patients with common variable immunodeficiency (CVID), the most frequently symptomatic primary immunodeficiency. Surveillance strategies for cancers in CVID should be defined based on epidemiological data. Risks and mortality for cancers among 455 Italian patients with CVID were compared to cancer incidence data from the Italian Cancer Registry database. CVID patients showed an increased cancer incidence for all sites combined (Obs = 133, SIR = 2.4; 95%CI = 1.7-3.5), due to an excess of non-Hodgkin lymphoma (Obs = 33, SIR = 14.3; 95%CI = 8.4-22.6) and of gastric cancer (Obs = 25; SIR = 6.4; 95%CI = 3.2-12.5). CVID patients with gastric cancer and lymphoma had a worse survival in comparison to cancer-free CVID (HR: 4.8, 95%CI: 4.2-44.4 and HR: 4.2, 95%CI: 2.8-44.4). Similar to what observed in other series, CVID-associated lymphomas were more likely to be of B cell origin and often occurred at extra-nodal sites. We collected the largest case-series of gastric cancers in CVID subjects. In contrast to other reports, gastric cancer was the leading cause of death in CVID. Standardized mortality ratio indicated a 10.1-fold excess mortality among CVID patients with gastric cancer. CVID developed gastric cancer 15 years earlier than the normative population, but they had a similar overall survival. Only CVID diagnosed at early stage gastric cancer survived >24 months. Stomach histology from upper endoscopy performed before cancer onset showed areas of atrophic gastritis, intestinal metaplasia or dysplasia. CVID patients might progress rapidly to an advanced cancer stage as shown by patients developing a III-IV stage gastric cancer within 1 year from an endoscopy without signs of dysplasia. Based on high rate of mortality due to gastric cancer in Italian CVID patients, we hereby suggest a strategy aimed at early diagnosis, based on regular upper endoscopy and on Helicobacter pylori infection treatment, recommending an implementation of national guidelines.
A Case Report of Massive Acetaminophen Poisoning Treated with a Novel "Triple Therapy": N-Acetylcysteine, 4-Methylpyrazole, and Hemodialysis
Authors: Emily A Kiernan, Julie A Fritzges, Kathryn A Henry, Kenneth D Katz
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Massive acetaminophen (N-acetyl-p-aminophenol; APAP) ingestion is characterized by a rapid onset of mitochondrial dysfunction, including metabolic acidosis, lactemia, and altered mental status without hepatotoxicity which may not respond to the standard doses of N-acetylcysteine (NAC). A 64-year-old woman without medical history presented comatose after an ingestion of 208 tablets of Tylenol PM™ (APAP 500 mg and diphenhydramine 25 mg). The initial APAP concentration measured 1,017 µg/mL (therapeutic range 10-30 µg/mL), and elevated anion gap metabolic acidosis, lactemia, and 5-oxoprolinemia were detected. High-dose intravenous (IV) NAC, 4-methylpyrazole (4-MP), and hemodialysis (HD) were initiated. She was transferred to a liver transplant center and continued both NAC and HD therapies until complete resolution of metabolic acidosis and coma without developing hepatitis. She was discharged without sequelae. This is the fourth highest APAP concentration recorded in a surviving patient. Moreover, this is the first report of a novel "triple therapy" using NAC, 4-MP, and HD in the setting of massive APAP ingestion that presents with coma, elevated anion gap metabolic acidosis, and lactemia. Emergency physicians should recognize these critically ill patients and consider high-dose NAC, 4-MP, and HD to be initiated in the emergency department (ED).
Outcome After Treatment With 15% Trichloroacetic Acid Peeling After Facial Black Powder Injury
Authors: Franzisca Ulrich, Leslie Elahi, Severin Alexander Rossi, Joachim Meuli, Wassim Raffoul
Journal: Aesthet Surg J Open Forum (2022)
MeSH terms: Case Reports

Explosion-related facial black powder injuries are difficult to treat due to traumatic tattooing of powder residue. A common treatment protocol consists of immediate debridement using a variety of surgical techniques with no other adjuncts. The results are often mediocre because of scarring or powder remnants on the skin. The authors present a patient who suffered innumerable black powder tattoos to the face after a cannon explosion treated by initial debridement and serial treatments of 15% trichloroacetic acid peelings with a highly satisfactory result.
The challenging diagnosis of pancreatic masses: not all tumors are cancers
Authors: Alessandro Morotti, Dario Gned, Leonardo Di Martino, Gaetano Cristaldi, Anna Alì, Paolo Nicoli, Andrea Veltri, Angelo Guerrasio
Journal: Case Rep Med (2015)

In the elderly patients, where biopsy-induced complications could outweigh the benefit, the identification of pancreatic masses is generally referred to as a synonymous of pancreatic cancer and patients are dismissed with no further options than palliative and supportive care. Notwithstanding, not all pancreatic tumors are cancers and therefore alternative diagnoses need to be investigated, especially when patients are unfit for invasive diagnostic procedures. Here, we report a case of an aged patient that was admitted to an internal medicine division for a previously diagnosed pancreatic cancer. The reassessment of the diagnosis has allowed identifying the pancreatic mass as a manifestation of focal pancreatitis in the context of an IgG4-related disease. Accordingly, patient was treated with steroids with rapid clinical improvement. This clinical case suggests that autoimmune diseases should always be considered in the differential diagnosis of pancreatic masses of the elderly.
Iodate induced toxic retinopathy: a case report
Authors: Y C Venu Gopal Reddy, Anuj Sharma, Adheesh P Shetty, Syed Mohideen Abdul Kader
Journal: Int J Retina Vitreous (2018)
Keywords: foveal atrophy, iodate, iodination of salt, toxic retinopathy
MeSH terms: Case Reports

Background:
Iodine deficiency is a common preventable cause of intellectual and developmental disabilities. Iodine in the form of potassium iodate is added to the common salt under the National Iodine Deficiency Disorder Control Program in India. Overdose of iodate can lead to retinal toxicity.
Case presentation:
We hereby present a case of a 34 year old male patient who presented to us 10 years following iodate ingestion. There was widespread outer retinal atrophy, foveal atrophy and sub-retinal fibrosis noted on fundus evaluation. The fundus fluorescein angiogram was suggestive of window defects while the scotopic electroretinogram showed diminished amplitude pointing towards a grave prognosis.
Conclusions:
Excessive ingestion of potassium iodate can lead to outer retinal atrophy due to its toxicity to the retinal pigment epithelium and photo-receptors. The degree of damage is dependent on the ingested dose.
Transient myocarditis associated with fulminant colitis
Authors: J M L Williamson, R S J Dalton
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Case Summary. An 18-year old man presented with a three-week history of abdominal pain, weight loss and bloody diarrhoea. He was profoundly septic, with generalised abdominal tenderness. CT and flexible sigmoidosopy confirmed colitis of the colon with rectal sparing. Laparotomy was performed when conservative management failed to improve his condition. Subtotal colectomy, with end ileostomy and mucus fistula formation, was performed in light of active colitis. Despite successful operative intervention the patient acute left ventricular failure, raising the possibility of giant cell myocarditis, which fully resolved before a definitive diagnosis could be reached. Discussion. It is possible that the transient cardiac failure in this case may represent an overwhelming inflammatory response or myocarditis. Inflammatory bowel disease is rarely associated with giant cell myocarditis (GCM). GCM usually affects a young population and its prognosis is variable, ranging from complete recovery, remission with recurrence and fatality. The management of this group of patients is still relatively experimental. Conclusion. Fulminant colitis can be associated with a rapid deterioration in cardiac function. Causes include sepsis, systemic inflammatory response syndrome or myocarditis. GCM should be considered in patients with new onset of left ventricular failure that decline rapidly.