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J Stroke Cerebrovasc Dis 2021 Apr 14;30(7):105773. Epub 2021 Apr 14.

Department of Neurosurgery, Nara Medical University, Kashihara, Japan. Electronic address:

Background: Duplication of the middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery (ICA). Aneurysms at the origin of a DMCA have been reported; however, most have been treated with clipping surgery. Here, we describe two cases of aneurysms at the origin of a DMCA treated with coil embolization. Read More

Int J Surg Case Rep 2021 Apr 7;82:105874. Epub 2021 Apr 7.

Dr Hedgewar Smruti Rugna Sewa Mandal Dental College and Hospital, Hingoli, India.

Introduction And Importance: The aim of this article is to report the long-term outcome of full mouth rehabilitation with single piece, smooth surface implants following immediate loading protocol on a patient suffering with RA and severe unilateral condylar resorption.

Case Presentation: Here, we present a challenging case of a patient suffering from Rheumatoid Arthritis who was stabilized and completed successfully with a 4 year follow-up period. Prosthetic management optimized the inter-occlusal relationship to maintain both function and esthetic integrity. Read More

Int J Surg Case Rep 2021 Apr 10;82:105882. Epub 2021 Apr 10.

Faculté de Médecine et Pharmacie, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco; Service de Stomatologie et chirurgie Maxillo-faciale, Hôpital 20 Août, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco.

Mucormycosis is an opportunistic fungal infection caused by molds within the order Mucorales. The rhino-orbital-cerebral localization is the most frequent. It is a destructive, necrotizing and potentially fatal disease. Read More

Int J Surg Case Rep 2021 Apr 7;82:105873. Epub 2021 Apr 7.

Esophageal Institute, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address:

Introduction: Acute gastric volvulus is a surgical emergency with a mortality as high as 15-20%. The rarity of gastric volvulus requires high index of clinical suspicion especially in the patients with altered anatomy, to allow immediate surgical intervention and reduce the morbidity and mortality.

Presentation Of Case: We present an unusual case of gastric remnant volvulus several months following Roux-en-Y esophagojejunostomy performed in an obese patient for severe, recurrent gastroesophageal reflux disease (GERD) and failed prior fundoplication. Read More

Int J Surg Case Rep 2021 Mar 16;82:105785. Epub 2021 Mar 16.

Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei City, 11490, Taiwan, ROC.

Introduction: Bladder urothelial carcinoma rarely spreads to the gastrointestinal tract, and its presentation in the rectum varies. We report a case of a patient who presented with an annular constriction of the rectum.

Presentation Of Case: A 60-year-old man was referred to our hospital with chief complaints of anal stricture and partial obstruction for about 1 month. Read More

Int J Surg Case Rep 2021 Apr 10;82:105881. Epub 2021 Apr 10.

Trumbull Regional Medical Center, USA.

Introduction & Importance: Adult Hirschsprung's disease (AHD) is a difficult diagnosis to make due to its rarity, frequently after emergency interventions have been conducted. We present a case of possible AHD and sketch a classic presentation of Adult Hirschsprung's Disease. This would help recognize and include AHD in the differential diagnoses of chronic constipation where appropriate. Read More

J Pediatr Adolesc Gynecol 2021 Apr 14. Epub 2021 Apr 14.

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China. Electronic address:

Background: Creating a functional neovagina is a practical therapeutic intervention for women with congenital vaginal agenesis and sexual needs. Although the incidence of neovaginal prolapse (NP) is low, it is inconvenient for patients and is a challenging problem for gynecologists.

Case: A 32-year-old woman who had undergone transabdominal sigmoid vaginoplasty 10 years previously at another hospital visited our clinic for evaluation and treatment of NP. Read More

Am J Case Rep 2021 Apr 17;22:e930902. Epub 2021 Apr 17.

Department of Pathology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

BACKGROUND Osteoma is a benign bone tumor that typically arises in facial bones and less frequently in the long bones. It rarely occurs in the appendiceal skeleton. Pathologic findings are similar to those for parosteal osteosarcoma, periostitis ossificans, and osteoid osteoma. Read More

Zh Vopr Neirokhir Im N N Burdenko 2021 ;85(2):80-90

Almazov National Medical Research Center, St. Petersburg, Russia.

Multiple gliomas are determined by synchronous two or more tumors located in different brain regions. It is important to distinguish multiple primary tumors and metastatic brain lesion. In the first case, tumor spread can`t be explained by dissemination along the cerebrospinal fluid pathways, commissural fibers or local metastases. Read More

Zh Vopr Neirokhir Im N N Burdenko 2021 ;85(2):5-16

Burdenko Neurosurgical Center, Moscow, Russia.

Central neurocytoma is a rare benign brain tumor. These tumors may be giant and accompanied by compression of ventricular system and surrounding structures. Modern treatment of brain neurocytoma includes extended resection and restoration of normal CSF circulation. Read More

Microsurgery 2021 Apr 17. Epub 2021 Apr 17.

Akdeniz University Faculty of Medicine, Antalya, Turkey.

Although there have been numerous reports of major replantation of upper extremity amputations, limited numbers of above-elbow amputation replantation have been reported. We present the technical details of two successful replantations of forequarter amputations in a nine-year-old girl and a three-year-old boy. In both cases, the forequarter was amputated due to avulsion traction injuries resulting in amputation including the entire upper limb, while the integrity of the scapula and parascapular muscles was maintained, with no injury to the glenohumeral joint. Read More

Microsurgery 2021 Apr 17. Epub 2021 Apr 17.

Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.

Chylous ascites is the leakage of lipid-rich lymph into the peritoneal cavity usually due to disruption of lymphatics or increased peritoneal lymphatic pressure. Various surgical options have been proposed to treat chylous ascites but most have shown suboptimal outcomes. The gastroepiploic vascularized lymph node (GE-VLN) flap has been described previously for the treatment of lymphedema. Read More

Int J Dermatol 2021 Apr 17. Epub 2021 Apr 17.

Department of Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco.

J Prosthodont 2021 Apr 17. Epub 2021 Apr 17.

Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain.

This report describes a prosthetically-driven implant planning method, guided by the alignment procedures between the cone beam computed tomography, intraoral digital scans, and digitized maxillary and mandibular interim complete dentures using intraoral composite resin markers as a common reference. The markers were attached to the keratinized oral mucosa of the edentulous ridges using cyanoacrylate and kept in place during the digitizing procedures. The technique provides a simpler and more economical alternative to conventional prosthetically-driven static implant planning methods. Read More

Neurol Sci 2021 Apr 16. Epub 2021 Apr 16.

Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10126, Turin, Italy.

We report here the first case of a young individual otherwise healthy, who presented with frequent focal seizures with impaired awareness as a possible long-term complication of severe acute respiratory syndrome coronavirus-2 infection. Seizures were documented by electroencephalography and responded clinically and neuro-physiologically to antiseizure therapy. The patient underwent an extensive investigation including cerebrospinal fluid examination, conventional and quantitative brain magnetic resonance imaging, and 18-FDG positron emission tomography. Read More

Sci Rep 2021 Apr 16;11(1):8347. Epub 2021 Apr 16.

Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, Rua do Matão 277, Cidade Universitária, São Paulo, SP, 05508-090, Brazil.

Micronucleoli are among the structures composing the peculiar scenario of the nucleolus in salivary gland nuclei of dipterans representative of Sciaridae. Micronucleolar bodies contain ribosomal DNA and RNA, are transcriptionally active and may appear free in the nucleoplasm or associated with specific chromosome regions in salivary gland nuclei. This report deals with an extreme case of nucleolar fragmentation/dispersion detected in the salivary gland of Schwenkfeldina sp. Read More

Am J Case Rep 2021 Apr 17;22:e928889. Epub 2021 Apr 17.

5G Law Firm, PLLC, Woodward, OK, USA.

BACKGROUND We report the case of a patient undergoing a colonoscopy during which pressure applied on the abdomen by a nurse assisting in the procedure caused an extraluminal mesenteric tear. Mesenteric tears can be life-threating and need to be managed appropriately. This is the first case reported in the literature describing abdominal counter-pressure applied in the endoscopic procedure room as the cause of traumatic bowel injury. Read More

Eur J Hosp Pharm 2021 Apr 16. Epub 2021 Apr 16.

Pharmacy Department, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium.

A female nursing home resident aged >70 years was admitted to the geriatric ward with de novo dysphagia 6 days after being discharged from the stroke unit. Metformin and ezetimibe had been added to her treatment regimen which already consisted of clopidogrel, atorvastatin, denosumab, calcium and vitamin D. At the geriatric ward a multidisciplinary team involving clinical pharmacists reviewed all treatments and appraised the time to benefit, ascertaining whether there was sufficient time left to experience therapeutic benefits. Read More

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Internal Medicine, Centro Hospitalar Universitário de Coimbra EPE, Coimbra, Portugal.

Angiosarcoma (AS) is a rare malignant tumour representing 1%-2% of all sarcomas. Primary AS of superior vena cava (SVC) was reported in two cases worldwide. We report a 69-year-old woman with neck discomfort, headache and dyspnoea for 3 months. Read More

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Ocular Oncology, The Operation Eyesight Univeraal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, Telangana, India

This case report demostrates an unusual occurence of peripunctal nevus and uveal melanoma, in which the clinical diganosis of uveal melanoma was masked by the atypical presentation as phthisis bulbi. Nevertheless, peculiar scleral pigment hinted at a possible intraocular tumour. The importance of meticulous clinical examination in assessment of ocular and periocular pigmented lesions is demonstrated. Read More

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Department of Surgery, Duchess of Kent Hospital, Sandakan, Malaysia.

De Garengeot hernia is a rare finding of the vermiform appendix inside a femoral hernia sac. We report this occurrence in a 73-year-old woman who presented in the acute setting. There are no standardised surgical approaches and many different techniques have been described in case reports in the literature. Read More

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

Department of Urology, Carle Foundation Hospital, Urbana, Illinois, USA.

Langerhans cell histiocytosis (LCH) is an uncommon group of disorders, which can be either localised or systemic, characterised by abnormal proliferation of monocytes, macrophages and dendritic cells. These disorders represent an aberrant response of myeloid progenitor cells. Bones are the most commonly affected organ but there can be involvement of the skin, lungs, liver and spleen. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Apr 13. Epub 2021 Apr 13.

CHU de Grenoble Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine Grenoble Alpes, 38700 La Tronche, France.

Cardiovasc Revasc Med 2021 Apr 6. Epub 2021 Apr 6.

Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, B-2650 Edegem, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, B-2610 Wilrijk, Belgium; Department of Cardiovascular diseases, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium.

Coronary embolism due to prosthetic valve thrombosis is a rare cause of acute coronary syndrome. We report the challenging case of a 66-year-old female patient with non-ST-elevation myocardial infarction caused by left main coronary artery bifurcation embolism in the setting of mechanical aortic valve thrombosis. The patient was treated with intravenous thrombolysis. Read More

Eur J Surg Oncol 2021 Apr 2. Epub 2021 Apr 2.

IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

The advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival in patients with peritoneal surface malignancies. Not surprisingly, there is now a growing interest on the possible means to preserve fertility to ensure future childbearing. In this study, we report on five women with peritoneal surface malignancies who performed ovarian hyper-stimulation and oocytes cryostorage prior to undergo CRS and HIPEC. Read More

J Emerg Nurs 2021 Apr 13. Epub 2021 Apr 13.

Kratom ingestion for its psychotropic effect or to self-treat opioid withdrawal symptoms has increased over the last 10 years in the United States. Although mild adverse effects have been observed in users, reports of respiratory failure and shock after kratom consumption remain rare. In this case, a 35-year-old man initially presented to the emergency department with profound circulatory shock, metabolic acidosis, hypoxia, and symptoms of autonomic nervous system dysfunction. Read More

J Emerg Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Emergency Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Background: Babesiosis, a tick-borne illness spread by Ixodes scapularis, is an emerging infectious disease in the Northeastern and upper Midwestern United States. Infection can present as a flu-like illness with anemia, thrombocytopenia, and jaundice. This disease can even be fatal in the immunocompromised or highly infected patient. Read More

J Emerg Med 2021 Feb 9. Epub 2021 Feb 9.

UC San Diego Health Sciences, UC San Diego Medical Center, San Diego, California.

Background: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most frequently presents with respiratory symptoms, such as fever, dyspnea, shortness of breath, cough, or myalgias. There is now a growing body of evidence that demonstrates that severe SARS-CoV-2 infections can develop clinically significant coagulopathy, inflammation, and cardiomyopathy, which have been implicated in COVID-19-associated cerebrovascular accidents (CVAs).

Case Report: We report an uncommon presentation of a 32-year-old man who sustained a large vessel cerebellar stroke associated with a severe COVID-19 infection. Read More

J Emerg Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Selayang, Batu Caves, Selangor, Malaysia.

Background: Fishbone ingestion represents a common cause for emergency department (ED) referral. In the majority of cases, an observed fishbone can be easily retrieved in the clinic setting. An impacted fishbone in the throat, albeit uncommon, carries potential risks of life-threatening events. Read More

Am J Emerg Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.

Pregnant patients are at increased risk of cerebrovascular accident due to the prothrombotic state of pregnancy. This risk is highest in those with pre-eclampsia and eclampsia as well as those of Asian descent. Despite this increased risk, pregnancy was an exclusion criterion for major stroke intervention trials. Read More