OpenMed/multicare-articles huggingface dataset:
Case report: Pacemaker lost capture after acute myocardial infarction in a patient with left circumflex coronary artery occlusion
Authors: Zhihong Wu, Jianjun Tang, Qingyi Zhu, Lin Hu, Zhenjiang Liu, Xuping Li, Qiming Liu, Shenghua Zhou, Mingxian Chen
Journal: Front Cardiovasc Med (2022)
Keywords: acute myocardial infarction, arrest, failure capture, pacemaker, sudden cardiac death
MeSH terms: Case Reports

A 71-year-old female with a dual-chamber pacemaker presented to our hospital complaining of repeated chest pain. She was diagnosed with unstable angina. On day 7, the patient suddenly suffered cardiopulmonary arrest due to an inferior ST segment elevation myocardial infarction (STEMI). Pacemaker lost capture was suspected and was later confirmed by a pacemaker check with a high pacing threshold and a low sensing parameter. Emergency coronary angiography revealed that a large filling defect remained due to an extensive thrombus in the proximal left circumflex (LCX) with thrombolysis in myocardial infarction (TIMI) grade 2 flow, and then a repeat thrombus aspiration was performed. After reperfusion, the parameters of the right ventricular lead were gradually returned. We conclude that the loss of the right ventricular lead pacing occurred in this case of acute coronary syndrome (ACS) induced by an LCX thrombus due to an LCX supplying the right ventricular septal.
Brain Network Activation as a Novel Biomarker for the Return-to-Play Pathway Following Sport-Related Brain Injury
Authors: Adam W Kiefer, Kim Barber Foss, Amit Reches, Brooke Gadd, Michael Gordon, Ken Rushford, Ilan Laufer, Michal Weiss, Gregory D Myer
Journal: Front Neurol (2015)
Keywords: eeg, brain network activation, concussion, hockey, return to play
MeSH terms: Case Reports

Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurological deficits. Objective assessments and return-to-play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury. In the present case study, we present a novel approach that examines event-related potentials via a brain network activation (BNA) analysis as a biomarker of concussion and recovery. Specifically, changes in BNA scores, as indexed through this approach, offer a potential indicator of neurological health as the BNA assessment qualitatively and quantitatively indexes the network dynamics associated with brain injury. Objective tools, such as these support accurate and efficient assessment of brain injury and may offer a useful step in categorizing the temporal and spatial changes in brain activity following concussive blows, as well as the functional connectivity of brain networks, associated with concussion.
Paraneoplastic Opsoclonus Myoclonus in a Patient with Pancreatic Adenocarcinoma
Authors: Divine C Nwafor, Ashley B Petrone, Joseph M Collins, Amelia K Adcock
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Opsoclonus myoclonus syndrome (OMS) is an extremely rare neurological syndrome typically affecting as few as 1 in 10,000,000 people annually. OMS is characterized by the presence of involuntary, saccadic eye movements, as well as ataxia, including gait incoordination, rigidity, and tremor. The origin of OMS is unclear, but a significant percentage of OMS cases are indicative of an underlying malignancy, most commonly neuroblastoma and small cell lung cancer. Here we describe an adult patient with OMS, who was ultimately diagnosed with a small ductal adenocarcinoma of the pancreas. To our knowledge, this is the third published report of an association between OMS and pancreatic malignancy, and the only case where the pancreatic malignancy was detected prior to metastasis or autopsy at death. This case report highlights the importance of careful, aggressive malignancy screening with OMS, as the pancreatic duct cut-off sign may be overlooked if pancreatic malignancy is not suspected.
Prenatal diagnosis of fetal peters' plus syndrome: a case report
Authors: Neerja Gupta, Anita Kaul, Madhulika Kabra
Journal: Case Rep Genet (2013)

Peters' plus syndrome is a rare but clinically recognizable autosomal recessive ocular genetic syndrome. Diagnosis during the fetal life is challenging due to the presence of nonspecific findings such as ventriculomegaly in the growth-retarded fetuses. We report the first case of fetal Peters' plus syndrome from India, where fetal ultrasound and the family history were helpful in providing a clue to the diagnosis that was confirmed later on by the DNA analysis.
Multiple Drug-Resistant CLABSI from an Extremely Rare Bacterium, Chryseobacterium gleum
Authors: David Anson, Benjamin Chaucer, Joseph Norton, Saurabh Bansal
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Chryseobacterium gleum is a lactose nonfermenting Gram-negative bacillus (NFGNB) found in soil, plants, and some water sources but rarely implicated as a human pathogen. Its scarcity in the medical literature and resistance to numerous broad-spectrum antibiotics such as carbapenems, cephalosporins, and beta-lactam/lactamase inhibitors pose a diagnostic and therapeutic challenge. We present the first reported case, to the best of our knowledge, of sepsis from central line-associated blood stream infection from Chryseobacterium gleum in the United States.
Contribution of Imaging in the Diagnosis of Cholangiocarcinoma in Choledochal Cyst
Authors: Djivèdé Witchékpo Maurice Mohamed Akanni, Kouassi Paul N'zi, Kofi-Mensa Savi de Tové, Laura Petrovai
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

The choledochal cyst is a rare congenital malformation of the bile ducts. It is considered as a precancerous state. The incidence of cancer in choledochal cyst increases with age and occurs around 32 years old. Therefore, young adults are often involved. In adults, clinical signs are rare and unspecific. We are reporting here the case of a cholangiocarcinoma in choledochal cyst in young adult diagnosed by ultrasonography, CT scan, and MRI and confirmed by histopathological examination.
Case Series of Potential Cardiac Inflammation Associated With Various SARS-CoV-2 Vaccinations Assessed by Cardiac MRI
Authors: Constantin Jahnke, Patrick Doeblin, Radu Tanacli, Undine Witt, Matthias Schneider, Christian Stehning, Burkert Pieske, Sebastian Kelle
Journal: Front Cardiovasc Med (2022)
Keywords: cmr, covid-19, sars-cov-2 vaccination, myocarditis, pericarditis
MeSH terms: Case Reports

Serious adverse events associated with new vaccines targeting SARS-CoV-2 are of high interest to the public and to public health as a worldwide mass immunization campaign has been initiated to contain the ongoing COVID-19 pandemic. We describe a series of 4 individuals with signs of a myocarditis/pericarditis according to cardiac MRI results in temporal association with currently in the European Union authorized SARS-CoV-2 vaccines. We found mild abnormal MRI results independent of the type of SARS-CoV-2 vaccine. There is a need of continuing monitoring outcomes of myocarditis cases after COVID-19 vaccination as recently published cases suggest an uncomplicated short-term course whereas the long-term implications are not yet known but taking the available evidence into account the benefits of using COVID-19 vaccines still clearly outweigh the risks.
Clinical and ultrasound findings of pentalogy of Cantrell in a newborn: A case report
Authors: Dan Wang, Bin Zheng, Bo Zhai, Juan Mo, Kaihua Yang, Yaling Huo
Journal: Front Pediatr (2022)
Keywords: case report, diverticulum, pentalogy of cantrell, ultrasound, ventricle
MeSH terms: Case Reports

Background:
Pentalogy of Cantrell is a rare and deadly syndrome, manifesting as intracardiac anomalies and ventricular diverticulum. Echocardiographers have an insufficient understanding of pentalogy of Cantrell, which may lead to missed diagnoses, especially in cases lacking the most obvious signs.
Case summary:
One of twin male infants, at a gestational age of 37 weeks, was found with a cardiac murmur and a pulsatile mass in the midline supraumbilical abdomen for 2 days. Echocardiography on admission indicated congenital heart disease. A cardiac murmur was detected in the 3-4 intercostal space and extensively spread. The infant was diagnosed with pentalogy of Cantrell by ultrasound and computed tomography angiography (CTA) preoperatively. The patient underwent heart deformity surgery and was followed up for 16 months. The patient's cardiac structure and function returned to normal.
Conclusion:
Intracardiac anomaly and ventricular diverticulum are the primary manifestations of pentalogy of Cantrell. Pentalogy of Cantrell may be diagnosed by combining the ultrasound and CTA findings.
Torsion of wandering spleen treated by laparoscopic splenopexy: A case report
Authors: Mariyem Awan, Jose Luis Gallego, Annett Al Hamadi, Vijay Chander Vinod
Journal: Int J Surg Case Rep (2019)
Keywords: acute abdomen, case report, laparoscopic splenopexy, torsion of spleen, wandering spleen

Introduction:
A wandering spleen is a mobile spleen as a result of deficient splenic peritoneal ligaments and elongation of its vascular pedicle. It is a rare entity affecting mainly young adults commonly females and children, presenting as an asymptomatic abdominal mass or abdominal discomfort due to torsion and de-torsion of the pedicle.
Presentation of case:
We report a 35-year-old female presented with intermittent colicky abdominal pain that worsened in severity over three weeks. Diagnostic laparoscopy showed torsion of spleen without infarction. Detorsion and Splenopexy in an extra-peritoneal pouch was performed. Post operatively, the patient recovered well and was healthy at two months follow up.
Discussion:
A wandering spleen is either congenital or acquired. The condition results in a long vascular pedicle, which predispose to the torsion resulting in a partial or complete infarct of the spleen. Laparoscopic approach is the preferred technique and de-torsion of the splenic pedicle and splenopexy is a reasonable surgical option, when there is no evidence of infarction of the spleen.
Conclusion:
The diagnosis of wandering spleen is very rare and extremely difficult to establish and is clinically nonspecific. An early diagnosis and surgical care are required for preserving the spleen. Additional imaging examinations can help establish a diagnosis.
Case Report: Amyloid-Producing Odontogenic Tumor With Pulmonary Metastasis in a Spinone Italiano-Proof of Malignant Potential
Authors: Callie Blackford Winders, Cynthia M Bell, Stephanie Goldschmidt
Journal: Front Vet Sci (2020)
Keywords: amyloid producing odontogenic tumor, dogs, neoplasia, odontogenic tumor, pathology—head and neck neoplasms
MeSH terms: Case Reports

A 1-year-old male Spinone Italiano dog was treated for an amyloid-producing odontogenic tumor on the right maxilla with a cytoreductive surgery followed by a definitive radiation protocol. Six years later, the dog presented for a new mass on the rostral mandible as well as a lung nodule without recurrence of the original maxillary tumor. Both the mandibular mass and the lung nodule were histologically confirmed to be amyloid-producing odontogenic tumor based on the appearance of sheets and cords of the odontogenic epithelium disrupted by amorphous extracellular amyloid. This case illustrates the metastatic potential for amyloid-producing odontogenic tumor in dogs and asynchronous occurrence of multiple APOTs in the oral cavity.
Combined Intracapsular And Extracapsular Neck Of Femur Fractures Case Series, Literature Review And Management Recommendations
Authors: Wasim Khan, Rhodri Williams, Sam Hopwood, Sanjeev Agarwal
Journal: Open Orthop J (2017)
Keywords: combined neck of femur fracture, constraint, hemiarthroplasty, internal fixation, segmental neck of femur fractures, total hip replacement

Concomitant ipsilateral intracapsular and extracapsular fractures of the femoral neck are rare injuries with only 14 cases described in the literature as single case reports. We present three cases that were successfully and uniquely treated by uncemented hip arthroplasties. Two patients underwent complex primary uncemented total hip replacements, and one patient underwent an uncemented bipolar fluted stem hemiarthroplasty. The level of bearing constraint varied between implants. After describing our cases we review the literature and make recommendations on the management of these injuries. We believe that these are significant injuries and best functional results can be achieved with an early diagnosis and patient-specific approach that can include a total hip replacement in appropriate cases.
An advanced pulmonary sarcomatoid carcinoma patient harboring a BRAFV600E mutation responds to dabrafenib and trametinib: a case report and literature review
Authors: Ruoxin Fang, Jun Gong, Zhengkai Liao
Journal: Front Oncol (2023)
Keywords: braf v600e mutation, case report, dabrafenib, pulmonary sarcomatoid carcinoma, trametinib
MeSH terms: Case Reports

Background:
The pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive subtype of NSCLC with rapid progression and poor prognosis, and is resistant to conventional chemotherapy. Most PSC cases have potential targetable genomic alterations. Approximately 7% of PSC patients have BRAF mutations, and the efficacy of dabrafenib and trametinib in BRAFV600E mutated PSC is unclear.
Case presentation:
Our report describes a patient with mutated BRAFV600E PSC who underwent surgery and adjuvant chemotherapy early but quickly relapsed. Both chemotherapy and immunotherapy were ineffective for him, combined dabrafenib and trametinib produced a 6-month progression-free survival, and a partial response was observed in the tumor response evaluation. As a result of financial pressure, he stopped taking the targeted drugs, and his disease rapidly progressed.
Conclusion:
Dabrafenib combined with trametinib provides partial remission in patients with advanced PSC with BRAFV600E mutations, and large-scale NGS panels could offer more options for PSC treatment.
Case Report: Long-term survival of a patient with advanced rectal cancer and multiple pelvic recurrences after seven surgeries
Authors: Ye Ouyang, Yilin Zhu, Haoyi Chen, Guoquan Li, Xiongwei Hu, Hongyu Luo, Zhou Li, Shuai Han
Journal: Front Oncol (2023)
Keywords: kras mutation, long-term survival, pelvic exenteration, rectal cancer, recurrence
MeSH terms: Case Reports

Background:
Rectal cancer has a high risk of recurrence and metastasis, with median survival ranging from 24 months to 36 months. K-RAS mutation is a predictor of poor prognosis in rectal cancer. Advanced rectal cancer can be stopped in its tracks by pelvic exenteration.
Case summary:
A 51-year-old woman was diagnosed with advanced rectal cancer (pT4bN2aM1b, stage IV) with the KRAS G12D mutation due to a change in bowel habits. The patient had experienced repeated recurrences of rectal cancer after initial radical resection, and the tumor had invaded the ovaries, sacrum, bladder, vagina and anus. Since the onset of the disease, the patient had undergone a total of seven surgeries and long-term FOLFIRI- or XELOX-based chemotherapy regimens, with the targeted agents bevacizumab and regorafenib. Fortunately, the patient was able to achieve intraoperative R0 resection in almost all surgical procedures and achieve tumor-free survival after pelvic exenteration. The patient has been alive for 86 months since her diagnosis.
Conclusions:
Patients with advanced rectal cancer can achieve long-term survival through active multidisciplinary management and R0 surgery.
Various clinical scenarios leading to development of the string sign of the internal thoracic artery after coronary bypass surgery: the role of competitive flow, a case series
Authors: Rudolf Kolozsvari, Zoltan Galajda, Tamas Ungvari, Gabor Szabo, Ildikó Racz, Tamás Szerafin, István Herzfeld, István Edes, Arpad Peterffy, Zsolt Koszegi
Journal: J Cardiothorac Surg (2012)
MeSH terms: Arterial Occlusive Diseases / etiology, Arterial Occlusive Diseases / physiopathology, Coronary Artery Bypass / adverse effects, Mammary Arteries / physiopathology, Mammary Arteries / transplantation, Regional Blood Flow, Case Reports, Aged, Female, Humans, Male, Middle Aged

Background:
The left internal mammary artery (LIMA) is the choice for grafting of the left anterior descending coronary artery (LAD). One possible mechanism of the rare graft failure involve the presence of competitive flow.
Method:
105 patients who had undergone coronary bypass grafting between 1998 and 2000 were included in this observational study. The recatheterizations were performed 28 months after the operations. The rate of patency the LIMA grafts was determined, and the cases with graft failure were analyzed.
Results:
The LIMA graft was patent in 99 patients (94%). Six patients (6%) exhibited diffuse involution of the graft (string sign). The string sign was always associated with competitive flow as the basis of the LIMA graft involution. In one case quantitative re-evaluation of the preoperative coronary angiography revealed merely less than 50% diameter stenosis on the LAD with a nonligated side-branch of the LIMA. At recatheterization in two patients the pressure wire measurements demonstrated only a non-significant decrease of the fractional flow reserve (0.83 and 0.89), despite the 53% and 57% diameter stenosis in the angiogram. Another patient displayeda significant regression of the LAD lesion between the pre- and postoperative coronary angiography (from 76% to 44%) as the cause of the development of the competitive flow. In one instance, a radial artery graft on the LAD during a redo bypass operation resulted in competitive flow in the radial graft due to the greater diameter than that of the LIMA. In a further patient, competitive flow developed from a short sequential part of the LIMA graft between the nonsignificantly stenosed diagonal branch and the LAD, with involution of the main part of the graft to the diagonal branch.
Conclusions:
The most common cause of the development of the string sign of a LIMA graft due to competitive flow is overassessment of the lesion of the LAD. Regression of a previous lesion or some other neighboring graft can also cause the phenomenon.
Anesthesia, pain management and surgical approach of ovariectomy or orchiectomy in six Egyptian fruit bats ( Rousettus aegyptiacus): A case report
Authors: Smadar Tal, Yael Shilo-Benjamini
Journal: Front Vet Sci (2023)
Keywords: egyptian fruit bat, rousettus aegyptiacus, analgesia, anesthesia, orchiectomy, ovariectomy
MeSH terms: Case Reports

The purpose of this report is to describe the anesthetic and analgesic management and the surgical procedures of gonadectomy in six (four females and two males) healthy adult Egyptian fruit bats (Rousettus aegyptiacus). Bats were anesthetized with a combination of alfaxalone, midazolam, and morphine administered subcutaneously. Incisional line infiltration using bupivacaine was administered in all bats, and additional bilateral intratesticular injection was administered in the males. Ovariectomy was performed via a dorsal approach, by bilateral midline skin incisions at the paralumbar fossa level. Orchiectomy was performed via a ventral approach, by bilateral midline incisions of scrotal skin above the testes. Following surgery, all bats were administered flumazenil for midazolam reversal, and meloxicam for postoperative analgesia, subcutaneously. All bats recovered from anesthesia uneventfully. Bats were monitored for complications up to 10 days following surgery, when skin sutures were removed. No morbidities or mortalities occurred during this period in any of the bats. In conclusion, ventral approach orchiectomy and dorsal approach ovariectomy using the injectable combination alfaxalone-midazolam-morphine in conjunction with local anesthesia and meloxicam are feasible procedures in Egyptian fruit bats and can be performed with relative ease. However, further studies using these techniques in a larger group of bats should be performed to establish their safety.
Bilateral Lower Extremity Paralysis in a Caucasian Male Presenting to the Emergency Department
Authors: Yicheng K Bao, Vishwanath C Ganesan, Richard Rapp, Shunzhong S Bao
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Reported is a case of a 39-year-old Caucasian man who presented to the emergency department with sudden onset bilateral lower extremity paralysis after consuming a large amount of carbohydrates and alcohol. A CT, MRI, and lumbar puncture were performed with negative results; lab results showed hyperthyroidism and hypokalemia. The patient was diagnosed with thyrotoxic periodic paralysis. In a patient presenting with sudden onset paralysis and hypokalemia, the emergency physician should include thyrotoxic periodic paralysis in the differential diagnosis and focus on treating and working up the hypokalemia instead of the paralysis.
"Down the language rabbit hole with alice": a case study of a deaf girl with a cochlear implant
Authors: Jean F Andrews, Vickie Dionne
Journal: Int J Otolaryngol (2011)

Alice, a deaf girl who was implanted after age three years of age was exposed to four weeks of storybook sessions conducted in American Sign Language (ASL) and speech (English). Two research questions were address: (1) how did she use her sign bimodal/bilingualism, codeswitching, and code mixing during reading activities and (2) what sign bilingual code-switching and code-mixing strategies did she use while attending to stories delivered under two treatments: ASL only and speech only. Retelling scores were collected to determine the type and frequency of her codeswitching/codemixing strategies between both languages after Alice was read to a story in ASL and in spoken English. Qualitative descriptive methods were utilized. Teacher, clinician and student transcripts of the reading and retelling sessions were recorded. Results showed Alice frequently used codeswitching and codeswitching strategies while retelling the stories retold under both treatments. Alice increased in her speech production retellings of the stories under both the ASL storyreading and spoken English-only reading of the story. The ASL storyreading did not decrease Alice's retelling scores in spoken English. Professionals are encouraged to consider the benefits of early sign bimodal/bilingualism to enhance the overall speech, language and reading proficiency of deaf children with cochlear implants.