OpenMed/multicare-articles huggingface dataset:
Case Report: Left Ventricular Unloading Using a Mechanical CPR Device in a Prolonged Accidental Hypothermic Cardiac Arrest Treated by VA-ECMO - a Novel Approach
Authors: Simon A Amacher, Jonas Quitt, Eva Hammel, Urs Zenklusen, Ayham Darwisch, Martin Siegemund
Journal: Front Cardiovasc Med (2021)
Keywords: accidental hypothermia, cardiac arrest, cardiopulmonary resuscitation, extracorporeal life support, harlequin syndrome, left ventricular unloading
MeSH terms: Case Reports

We recently treated a 36-year-old previously healthy male with a prolonged hypothermic (lowest temperature 22.3°C) cardiac arrest after an alcohol intoxication with a return of spontaneous circulation after 230min of mechanical cardiopulmonary resuscitation and rewarming by veno-arterial ECMO with femoral cannulation and retrograde perfusion of the aortic arch. Despite functional veno-arterial ECMO, we continued mechanical cardiopulmonary resuscitation (Auto Pulse™ device, ZOLL Medical Corporation, Chelmsford, USA) until return of spontaneous circulation to prevent left ventricular distention from persistent ventricular fibrillation. The case was further complicated by extensive trauma caused by mechanical cardiopulmonary resuscitation (multiple rib fractures, significant hemothorax, and a liver laceration requiring massive transfusion), lung failure necessitating a secondary switch to veno-venous ECMO, and acute kidney injury with the need for renal replacement therapy. Shortly after return of spontaneous circulation, the patient was already following commands and could be discharged 3 weeks later without neurologic, cardiac, or renal sequelae and being entirely well. Prolonged accidental hypothermic cardiac arrest might present with excellent outcomes when supported with veno-arterial ECMO. Until return of spontaneous circulation, one might consider continuing with mechanical cardiopulmonary resuscitation in addition to ECMO to allow some left ventricular unloading. However, the clinician should keep in mind that prolonged mechanical cardiopulmonary resuscitation may cause severe injuries.
Cat scratch colon
Authors: M Lourdes Ruiz-Rebollo, Benito Velayos-Jiménez, José María Prieto de Paula, María Alvarez Quiñones, José Manuel González Hernández
Journal: Diagn Ther Endosc (2011)
MeSH terms: Case Reports

Over the past few years, we have read several publications regarding the term "cat scratch colon." This neologism was developed to define some bright red linear markings seen in the colonic mucosa that resemble scratches made by a cat. We would like to communicate a recent case attended at our institution.
Case report: Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay: Three cases and a literature review
Authors: Xiangyuan Chen, Fang Fu, Xiaolan Mo, Suyun Cheng, Huasong Zeng
Journal: Front Pediatr (2023)
Keywords: sifd, trnt1, developmental delay, immunodeficiency, periodic fever
MeSH terms: Case Reports

Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay (SIFD) is a serious autosomal recessive syndrome caused by biallelic mutations in cytosine-cytosine-adenosine tRNA nucleotidyltransferase 1 (TRNT1). The main clinical features of SIFD are periodic fevers, developmental delay, sideroblastic or microcytic anemia, and immunodeficiency. Herein, we report three cases of SIFD with compound heterozygous variants of TRNT1. Patients 1 and 2 were siblings; they presented with periodic fevers, arthritis, low immunoglobulin A, bilateral cataracts, anemia, and neurodevelopmental and developmental delay. Patient 3 had severed clinical features with recurrent fever and infections. She was treated with infliximab and symptomatic treatments but without therapeutic effect. She received a stem cell transplantation of umbilical cord blood but died of posttransplant infection and posttransplant graft-vs.-host disease 17 days after transplantation. Finally, a literature review revealed that TRNT1 variants differed among SIFD patients. Our cases and literature review further expand existing knowledge on the phenotype and TRNT1 variations of SIFD and suggest that the early genomic diagnosis of TRNT1 is valuable to promptly assess bone marrow transplantation and tumor necrosis factor inhibitor treatments, which might be effective for the immunodeficiency and inflammation caused by SIFD.
A MacIntyrean account of chronic moral injury: Assessing the implications of bad management and marginalized practices at work
Authors: Lily M Abadal, Garrett W Potts
Journal: Front Sociol (2022)
Keywords: alasdair macintyre, management, manager, moral injury, virtue

In this article, we engage with a theory of management advanced by MacIntyrean scholars of business ethics and organization studies to develop an account of "chronic moral injury" in the workplace. In contrast to what we call "acute moral injury," which focuses on grave, traumatic events, chronic moral injury results from poor institutional form-when an individual desiring excellence must function within a vicious institution that impedes the acquisition of virtues and marginalizes practices. In other words, chronic moral injury occurs when practitioners who pursue excellence in their practice work within corrupt or malformed organizations. To demonstrate this point, we recount the events associated with the rise and fall of the biotech company, Theranos. This case study advances an empirical contribution to MacIntyrean studies by demonstrating how chronic moral injury can happen under such conditions and what the negative consequences may entail for workers.
Unexpected outcome from Trousseau syndrome
Authors: Sri G Thrumurthy, Abeyratne H M P Anuruddha, Merrenna I M De Zoysa, Dharmabandhu N Samarasekera
Journal: BMC Surg (2011)
MeSH terms: Adenocarcinoma / complications, Paraneoplastic Syndromes / etiology, Stomach Neoplasms / complications, Thrombophlebitis / etiology, Case Reports, Adenocarcinoma / surgery, Adult, Humans, Male, Stomach Neoplasms / surgery

Background:
Unprovoked superficial thrombophlebitis and subsequent venous thromboembolism are well-described albeit rare presenting features of advanced visceral malignancy that often manifest too late for curative intervention to be beneficial.
Case presentation:
We present the first reported case of early gastric carcinoma presenting with these paraneoplastic phenomena in an otherwise healthy farmer. The early presentation allowed for a curative partial gastrectomy, which itself was complicated by the presence of a deep vein thrombosis extending into the inferior vena cava. Fortunately, stabilization of the clot allowed for surgery to proceed without the need for a caval filter. The patient was referred for adjuvant chemotherapy and has since made an excellent recovery.
Conclusions:
This case provides new evidence for the presentation of superficial thrombophlebitis in early gastric carcinoma and the potential for curative surgery in such instances. A high index of suspicion and a prompt diagnostic workup are essential for timely planning and execution of surgery in these early albeit rare presentations.
Mucus-filled lesion of a distal viable remnant tip of an appendix that developed 23 years after appendectomy
Authors: Hidenori Tomida, Shinichi Hashimoto, Masahiro Hayashi, Masamichi Koyama
Journal: Int J Surg Case Rep (2020)
Keywords: appendiceal stump, appendix, distal viable remnant tip of appendix, incomplete appendectomy, post-appendectomy mucus-filled lesions, surgical complication
MeSH terms: Case Reports

Introduction:
Post-appendectomy mucus-filled lesions, arising from appendiceal remnant tissue, are an exclusively rare clinical entity. We report a rare case of a mucus-filled lesion rising from a distal viable remnant appendiceal tip as a late complication of appendectomy.
Presentation of case:
A 48-year-old man presented with a 2-week history of right buttock and right lower quadrant abdominal pain. He had previously undergone appendectomy 23 years ago. Radiological examination showed a cystic lesion lateral to the colon with a prominent tubular structure. According to the past operative note, the appendiceal tip was lost accidentally. Surgical resection was performed. Pathologic examination revealed a mucus-filled lesion lateral to the cecum, with no communication between them. There was no evidence of malignancy. The prominent structure had muscular layer, suggestive of distal appendiceal remnant.
Discussion:
Surgical resection of appendiceal mucus-filled lesion is recommended, because there are no reliable criteria to exclude malignant lesions. Although appendiceal mucus-filled lesion is rare, it is extremely rare in patients with previous appendectomy. In our case, the mucinous material secreted from the remnant appendix might be enclosed by the surrounding tissue.
Conclusion:
In patient with previous appendectomy who show a cystic mass close to the cecum, the possibility of lesion derived from the appendiceal stump or distal appendiceal remnant should be considered. In such cases, it is important to review the medical records for a definitive diagnosis. Complete appendectomy, without leaving appendiceal tissue, remains mandatory to prevent the development of late complications of mucus-filled lesions.
Fungal infection mimicking COVID-19 infection - A case report
Authors: Aleksandra Niemiec, Michał Kosowski, Marcin Hachuła, Marcin Basiak, Bogusław Okopień
Journal: Open Med (Wars) (2022)
Keywords: covid-19 pneumonia, differential diagnosis, fungal pneumonia, high-resolution computed tomography
MeSH terms: Case Reports

For the last 2 years, one of the most frequent causes of respiratory failure is coronavirus disease 2019 (COVID-19). The symptoms are not specific. Imaging diagnostics, especially high-resolution computed tomography, is a diagnostic method widely used in the diagnosis of this disease. It is important to emphasize that not only SARS-CoV-2 infection may manifest as interstitial pneumonia. Other diseases such as other viral, fungal, atypical bacterial pneumonia, autoimmune process, and even cancer can also manifest as ground-glass opacities or consolidations in the imaging of the lungs. In this case report, we described a patient who manifested many symptoms that seemed to be COVID-19. However, all performed antigen and polymerase chain reaction tests were negative. The diagnostics must have been extended. Microbiological and mycological blood cultures and sputum cultures were performed. Blood cultures were negative but in sputum, Candida albicans and Candida glabrata were identified. Targeted therapy with fluconazole was implemented with a satisfactory result. The patient was discharged from the hospital in a good general condition with no complaints.
Delayed Presentation of Suture Erosion following Burch Colposuspension
Authors: Robert Shapiro, Ali Hajiran, Stanley Zaslau
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Background:
Synthetic mid-urethral mesh slings are the most common primary surgical treatment for stress urinary incontinence (SUI) and have been designated as the standard of care by the American Urogynecologic Society. In recent years, synthetic mesh has come under increased scrutiny by the Federal Drug Administration (FDA) due to concerns over patient safety. This has led to more surgeons and patients preferring Burch colposuspension to treat SUI.
Case:
We discuss two cases of suture erosion into the urethra and bladder. They presented with irritative voiding symptoms and recurrent urinary tract infections. Both were discovered years after a Burch colposuspension.
Conclusion:
As reported in the literature as early as 1999, erosion is a complication associated with many types of incontinence surgery and not unique to mesh based sling operations. Burch colposuspension should not be favored solely to avoid erosion and patients should be counseled accordingly.
Teaching point:
Cystourethroscopy performed intraoperatively or postoperatively is essential for early diagnosis and treatment of complications related to incontinence surgery.
Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
Authors: Sowmya Krishnan, Swapna Deshpande, Ashwini Mallappa, Gunda Divya, Pascale Lane, Anu Vishwanath, Rene Y McNall-Knapp
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Chronic hyponatremia is very rare in children and is often seen in the setting of congestive heart failure or liver failure in adults. Here, we report an 8-year-old child with hypothalamic glioma who presented with severe hyponatremia. Initial management consisted of fluid restriction. This was very difficult for the child to follow and the child developed bizarre drinking habits requiring intervention from child psychiatry. So therapy was initiated with low dose V2 receptor antagonist under close inpatient monitoring. While initial response was reassuring, her sodium levels tended to drift down with longer duration of treatment requiring us to increase the dose frequently. Her response to therapy and her stable clinical situation off therapy suggest that she may have reset osmostat.
Analysis of the genotype-phenotype correlation in isovaleric acidaemia: A case report of long-term follow-up of a chinese patient and literature review
Authors: Xingmiao Liu, Xinquan Liu, Wenxuan Fan, Zhongbin Zhang, Peiyuan Zhang, Xiaojun Liu, Meifang Lei, Qing Li, Xiaoli Yu, Dong Li
Journal: Front Neurol (2022)
Keywords: case report, genotype-phenotype correlation, inherited metabolic disease, isovaleric acidaemia, isovaleryl-coa dehydrogenase (ivd)
MeSH terms: Case Reports

Background:
Isovaleric acidaemia (IVA), characterized by an acute metabolic crisis and psychomotor delay, is a rare inherited metabolic disease caused by a deficiency in isovaleryl-CoA dehydrogenase (IVD).
Methods:
We report the case of a Chinese patient with IVA who was admitted to Tianjin Children's Hospital and followed up for 8 years. Genetic analysis of the patient and his parents was conducted using the whole-exome sequencing and Sanger sequencing. We searched for similar reported cases in the PubMed and Wanfang databases using the term "isovaleric acidaemia," reviewed the related literature to obtain a summary of the clinical and genetic characteristics, and analyzed the genotype-phenotype correlations.
Results:
The patient presented with encephalopathic symptoms, such as vomiting, lethargy, and somnolence. We identified compound heterozygous variants of the IVD gene, including the unreported variant c.224A>G (p.Asn75Ser) and the reported variant c.1195G>C (p.Asp399His). The child was prescribed a low-protein diet supplemented with L-carnitine. During the 8-year follow-up, no metabolic disorder or encephalopathic symptoms recurred. At present, the child is 11 years of age and has normal mental and motor performance. Another 154 cases identified in 25 relevant references were combined with this case, resulting in a sample of 155 patients, including 52 asymptomatic patients, 64 with neonatal onset, and 39 with the chronic intermittent disease with onset from ages of 1 month to 10 years (median age, 2 years). Among articles that reported sex, the male-to-female ratio was 1:1.06. The cardinal symptoms included vomiting, lethargy, "sweaty foot" odor, poor feeding, developmental delay, and epilepsy. The proportion of variants in regions 123-159 and 356-403 of the IVD protein was greater in symptomatic patients than in asymptomatic patients. Conversely, in asymptomatic patients, the proportion of variants in the 282-318 region was greater than in symptomatic patients.
Conclusion:
This case report describes an unreported variant c.224A>G (p.Asn75Ser) of the IVD gene, and summarizes previously reported cases. Furthermore, the correlation between the genotype and clinical phenotype of IVA is analyzed to improve the understanding of this disease.
Case report: Recreational nitrous oxide abuse triggered peripheral neuropathy possibly through the immune-mediated pathogenesis
Authors: Mei-Xue Dong, Qing Wang, Jun-Feng Xu, Ling Hu, Ying Yu, Tao Li
Journal: Front Neurol (2022)
Keywords: guillain-barré syndrome, ganglioside complexes, immunoglobin, nitrous oxide, peripheral neuropathy, steroid hormone
MeSH terms: Case Reports

Nitrous oxide (N2O), commonly known as laughing gas, is widely used in clinical practice and food industry. However, an increasing number of young people have been abusing N2O for recreational purpose, resulting in many functional disorders and sometimes irreversible nerve damage. We present the case of a 20-year-old N2O abuser who gradually developed peripheral neuropathy after continuously inhaling N2O for 2 months. The neurological symptoms of the patient had kept exacerbation for the next 2 months until she came for medical care sitting in a wheelchair. We suggested the patient halting N2O intake and supplementing methylcobalamine according to the standardized protocol. Her symptoms had partly recovered during the following 2 weeks but remained unchanged in another 2 weeks. Antibodies against ganglioside complexes were detected and anti-GM1 IgM antibodies were positive in both cerebrospinal fluid and serum. Intravenous immunoglobulin was given as an additional treatment and the patient's symptoms had significantly recovered further. The patient discharged walking by herself. Then she has been continuously followed up in outpatient department for the next 4 months and taking steroid hormone as well as methylcobalamine. Her symptoms gradually disappeared and all the electrophysiological parameters significantly improved. With this case we were able to show that N2O-related peripheral neuropathy is not only a metabolic disorder but also an immune-mediated disease. N2O intake can trigger a mimic Guillain-Barré syndrome.
A Rare Case Report of Thoracic Ectopia Cordis: An Obstetrician's Point of View in Multidisciplinary Approach
Authors: Diana Ramasauskaite, Vilija Snieckuviene, Viktorija Zitkute, Ramune Vankeviciene, Dalia Lauzikiene, Grazina Drasutiene
Journal: Case Rep Pediatr (2016)

Ectopia cordis is a rare congenital anomaly associated with the heart positioned outside of the thoracic cavity either partially or completely. It can be associated with other congenital abnormalities. Overall, the prognosis for infants with ectopia cordis is very poor but depends greatly on the type and severity of ectopia cordis and intracardiac and associated malformations. We present one case of a fetus with prenatally diagnosed thoracic ectopia cordis with intracardiac defects and omphalocele, all the abnormalities seen in pentalogy of Cantrell except a diaphragmatic defect. Considering poor prognosis for fetus, conservative management of prenatal care has been chosen. At the 42nd gestational week, during the active stage of labor, due to fetal distress, cesarean section was performed at a tertiary level hospital. The condition of the infant was impairing rapidly and the newborn succumbed within 24 hours. We discuss the perinatal care concerning this rare anomaly.
Pre-workout Induced Demand Ischemia
Authors: Miguel A Rodriguez Guerra, Ana P Urena Neme, Mohammed Shaban, Constangela Matos Noboa, Tiffany Trinh
Journal: Cureus (2023)
Keywords: demand ischemia, pre-workout supplement, sinus tachycardia, subclinical hypothyroidism, troponinemia
MeSH terms: Case Reports

Pre-workout supplement use has increased in recent years. Multiple side effects and off-labeled substances have been reported. We report a case of a 35-year-old patient who recently started a pre-workout and was found to have sinus tachycardia, elevated troponin, and subclinical hyperthyroidism. The echocardiogram showed normal ejection fraction and no wall motion abnormality. Beta-blockade therapy with propranolol was offered, but she refused, and her symptoms and troponin levels improved after proper hydration within 36 hours. A cautious and accurate assessment of young, fitness-enthusiastic patients experiencing unusual chest pain is essential to identify a reversible cardiac injury and possible off-label substances in over-the-counter supplements.
Giant prolactinoma: case report and review of literature
Authors: Masoud Rahmanian, Hamidreza Aghaei Meybodi, Bagher Larijani, Mohammad-Reza Mohajeri-Tehrani
Journal: J Diabetes Metab Disord (2013)
MeSH terms: Case Reports

"Invasive giant prolactinoma" is a large prolactinoma (>4 cm in dimension) presenting with serum prolactin levels of >1000 ng/dL and mass related clinical symptoms. Here we report a patient with a giant prolactinoma presented with central hypogonadism, suppressed adrenal and thyroid function, supra sellar extension, visual field impairment and high prolactin level.The patient was treated with cabergoline, levothyroxin and prednisolone. After 18 months, tumor size markedly reduced, associated with adrenal function and visual field improvement, but central hypogonadism and secondary hypothyroidism persisted.Previous studies showed normalization of thyrotropin secretion after treatment but it remained low in our patient even after 18 months follow up.
Case Report: Mucus plug in bronchus mimicking a bronchial solid foreign body obstruction
Authors: Kiran Devkota, Miao He, You Wei Zhang
Journal: F1000Res (2017)
Keywords: bronchial obstruction, foreign body, plastic bronchitis

Bronchial foreign body obstruction is common in all clinical settings. Obstruction of the airway due to foreign bodies and foreign body aspiration are major causes of childhood mortality and morbidity, which are a big challenge to manage. Occasionally, bronchial obstruction may be due to mucus plugs or other endogenous factors. Here we describe a case of bronchial obstruction caused by mucus plug formation that was managed conservatively in a one-year old boy. The patient was suffering from a cough and noisy breathing for 2 days prior to coming to our hospital, when he experienced sudden onset of difficulty in breathing and a severe cough. At the time of presentation his vital sign readings were:- HR 186 bpm, RR 46/min, BP 78/40 MmHg, temp 36.9°C and SPO2 68%. He was given oxygen immediately and nebulization was started. Chest CT scan was performed that suggested the presence of a right bronchial foreign body with right sided obstructive emphysema. The patient was stable with oxygenation and nebulization with ipratropium bromide, albuterol, normal saline and budesonide before the CT scan. Therefore, we conclude that symptoms resembling foreign body obstruction are not always aspirated or inhaled, and sometimes secreted sputum forms a plug, which mimics the symptoms of foreign body obstruction.
Drug-induced liver injury caused by adalimumab: a case report and review of the bibliography
Authors: Bernardo Frider, Andres Bruno, Marcelo Ponte, Marcelo Amante
Journal: Case Reports Hepatol (2013)

The most serious adverse drug reaction of adalimumab (ADR) is tuberculosis reactivation. We describe a case of a 35-year-old man, with rheumatoid arthritis (RA) and hepatitis C virus genotype 1a with a liver biopsy in 2001 with a METAVIR score pattern A1 F0; he received interferon alpha 2b for six months, but treatment was suspended because of reactivation of RA. Liver function tests after treatment were similar to previous ones showing a minimal cholestatic pattern. In 2008, methotrexate was prescribed, but the drug was withdrawn at the third month because of the appearance of pruritus and Ggt rise. Viral load at that moment was 9300000 UI/mL, log 6,9. The liver biopsy showed a Metavir Score A2 F1. Adalimumab was started in 2010, and at the third month of treatment, Ggt showed a rise of 23 times normal value (NV), alkaline phosphatase 2,5 times NV with AST and ALT with no change. A new liver biopsy showed portal inflammation with eosinophils and a METAVIR A1 F2. We think that adalimumab appears to be responsible for the liver injury, because of temporal relationship, liver biopsy findings, other clinical conditions being discarded, and the improvement of clinical symptoms and biochemical abnormalities when adalimumab was suspended.