OpenMed/multicare-articles huggingface dataset:
Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
Authors: Qinglin Wu, Fulan Cen, Guowei Wang, Jia Huang
Journal: Front Med (Lausanne) (2023)
Keywords: acute respiratory distress syndrome (ards), case report, extracorporeal membrane oxygenation (ecmo), pneumocystis jirovecii pneumonia (pjp), venovenous ecmo (vv-ecmo)
MeSH terms: Case Reports

Introduction:
Patients suffering from severe acute respiratory distress syndrome (ARDS) are usually treated with mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has traditionally been considered a life-saving therapy and was reserved as a last resort when other treatment options were exhausted. However, this report outlines our successful initial experience with early implementation of awake venovenous extracorporeal membrane oxygenation (VV-ECMO) in a case of pneumocystis jirovecii pneumonia complicated by severe acute respiratory distress syndrome (ARDS), offering a promising new approach for recovery.
Case presentation:
We present a case report of the effective application of awake VV-ECMO in a 29 years-old man with severe ARDS caused by pneumocystis jirovecii pneumonia. The patient initially received antibiotic treatment and non-invasive ventilation (NIV) for respiratory distress, but these interventions failed to improve the worsening dyspnea that occurred in the patient. Following the combined antifungal therapy, high-flow nasal cannula (HFNC) oxygen therapy, and VV-ECMO for a duration of 7 days, the patient's symptoms improved, showing relief.
Conclusion:
Awake VV-ECMO proved to be an effective treatment for critically ill patients with ARDS, avoiding the need for invasive mechanical ventilation. However, increased clinical evidence is needed to verify whether awake ECMO could be widely used in severe ARDS caused by other diseases or conditions.
Case report of a family with hereditary inclusion body myopathy with VCP gene variant and literature review
Authors: Greta Asadauskaitė, Ramunė Vilimienė, Vytautas Augustinavičius, Birutė Burnytė
Journal: Front Neurol (2023)
Keywords: vcp gene, vcp related disease, degenerative disease, inclusion body myopathy, multisystem proteinopathy
MeSH terms: Case Reports

Background:
Missense VCP gene variants lead to a disruption in protein homeostasis causing a spectrum of progressive degenerative diseases. Myopathy is the most frequent manifestation characterized by slowly progressing weakness of proximal and distal limb muscles. We present a family with myopathy due to c.277C > T variant in VCP gene.
Case presentation:
The patient's phenotype includes symmetrical muscle wasting and weakness in the proximal parts of the limbs and axial muscles, a wide based gait, lordotic posture, positive Gowers' sign, mild calf enlargement, impaired mobility, elevated CK, and myopathy in proximal limb muscles. Whole body MRI revealed fatty replacement, predominantly affecting right vastus intermedius and medialis, gastrocnemius and soleus in calf, abdomen wall and lumbar muscles. Next-generation sequencing analysis revealed a pathogenic heterozygous variant c.277C > T (p.(Arg93Cys)) in exon 3 of the VCP gene. Segregation analysis showed that the detected variant is inherited from the affected father who developed symptoms at 60.
Conclusion:
The patients described experienced muscle wasting and weakness in the proximal and distal parts of the limbs which is a common finding in VCP related disease. Nevertheless, the patient has distinguishing features, such as high CK levels, early onset of the disease, and rapid mobility decline.
Infarct Size Reduction in an Anterior ST-Elevation Myocardial Infarction Following "Optimized" Supersaturated Oxygen Therapy
Authors: Kamran Zaheer, Shaden Daloub, Mohamed Suliman, Kanaan Mansoor, Rameez Sayyed
Journal: Cureus (2024)
Keywords: infarct size reduction, post-pci for lad stemi, primary percutaneous coronary intervention (pci), st-elevation myocardial infarction (stemi), supersaturated oxygen therapy (sso2)
MeSH terms: Case Reports

This comprehensive case report documents the treatment of a 37-year-old female patient who presented with anterior ST-elevation myocardial infarction (STEMI). The patient underwent percutaneous coronary intervention (PCI), followed by an innovative therapy - optimized supersaturated oxygen therapy (SSO2). This therapy was chosen due to its potential to enhance myocardial salvage, particularly in severe MI cases like the patient. The report meticulously details the patient's clinical course, including the diagnostic procedures and the rationale behind opting for SSO2 therapy. It highlights the significant improvements observed post-therapy: enhanced left ventricular (LV) function and a remarkable reduction in the size of the LV apical aneurysm. These outcomes suggest a direct benefit of SSO2 in reducing myocardial damage. Finally, the report discusses the broader implications of these findings. It underscores the potential of optimized SSO2 therapy in clinical settings, particularly for patients with anterior MI. The case exemplifies how advanced therapeutic interventions like SSO2 can play a pivotal role in improving clinical outcomes post-MI, thereby advocating for its consideration in similar clinical scenarios.
Compounding impacts of COVID-19, cyclone and price crash on vanilla farmers' food security and natural resource use
Authors: Henintsoa Rakoto Harison, James P Herrera, O Sarobidy Rakotonarivo
Journal: PLoS One (2024)
MeSH terms: COVID-19 / economics, COVID-19 / epidemiology, Cyclonic Storms, Farmers / psychology, Food Security, Adult, Agriculture / economics, Female, Humans, Madagascar / epidemiology, Male, Natural Resources, Pandemics / economics, SARS-CoV-2

The intersection of the COVID-19 pandemic with other crises can amplify vulnerabilities and push communities further into poverty. In low-income countries, the dual impacts of COVID-19 and extreme weather events, along with multidimensional poverty and structural vulnerabilities in agriculture can decimate farmer livelihoods. This study aims to understand the effects of individual and compounding crises (COVID-19, cyclones, and vanilla price collapse) on smallholder vanilla farmers and local coping strategies in Madagascar, one of the world's largest vanilla producers and poorest countries. We used semi-structured and scenario-based interviews across two case study villages with contrasting enforcement of forest regulations. We found that the impact of the pandemic, combined with the cyclone event, disrupted livelihoods, resulting in income losses and food security challenges that exacerbated farmer vulnerabilities. Sixty eight percent of households reported crop losses due to strong winds and heavy rainfall brought by cyclone Enawo in 2017. The COVID-19 outbreak struck the region just as the residents were recovering from the effects of the cyclone. COVID-19-related travel restrictions in the aftermath of the cyclone took a substantial economic toll, with 54.1% of respondents experiencing a decline in earnings, and 17% facing a total loss of income due to the imposed lockdown. The decline in vanilla prices at the onset of 2020 had a far-reaching additional impact, affecting not only farmers but also residents who rely on other sources of income. Local communities reported using the forest resources more frequently as a safety net during crises in the village with more lenient regulations. This study underscores the importance of understanding the interconnectedness and compounding impacts of cascading crises on food security and natural resource use. We highlight the need for a comprehensive approach to increasing farmer resilience, particularly for those reliant on global market crops such as vanilla.
Unveiling the Unusual: A Unique Case of Verrucous Cyst
Authors: Zaryab Alam, Michelle S Bach, Mojahed Shalabi, Shannon C Brown
Journal: Cureus (2024)
Keywords: cytological atypia, epidermoid cysts, human papillomavirus (hpv), pcr test, verrucous cysts
MeSH terms: Case Reports

Verrucous cysts are uncommon types that cannot be distinguished from epidermal inclusion cysts clinically and require histopathological analysis and human papillomavirus (HPV) polymerase chain reaction (PCR) for accurate diagnosis. The pathogenesis of verrucous cysts is thought to involve HPV infection, either of an existing cyst or through direct infection of keratinocytes, leading to new cyst formation. While verrucous cysts can affect individuals of any sex and are typically found on the trunk, extremities, and face, they are particularly notable for their potential association with high-risk HPV types, such as 16 and 18, which may lead to malignant transformation. In this report, we present the case of a 48-year-old female with a history of endometriosis and pelvic inflammatory disease, who sought evaluation for a persistent subcutaneous nodule on her right flank. The patient reported pain, a recent color change, and an increase in the nodule size. Clinical examination revealed a 2.7 cm subcutaneous nodule with a central brown-gray papule. Despite no history of dermatologic malignancies, the nodule was excised, and subsequent histopathological examination confirmed a diagnosis of a ruptured verrucous cyst. The cyst exhibited acanthotic papillomatous squamous epithelium without cytologic atypia and koilocytic change in cells. This case offers direct and valuable insights into the clinical presentation, diagnosis, and management of verrucous cysts. It highlights the importance of a thorough diagnostic approach, combining histopathological examination with HPV PCR testing, to accurately differentiate verrucous cysts from other similar cutaneous lesions. The report also emphasizes the need for vigilance in managing these cysts due to their potential association with high-risk HPV types and the consequent risk of malignant transformation. These insights contribute significantly to the existing body of literature on verrucous cysts and aim to enhance clinical awareness and patient care in dermatology.
Mosaic Turner Syndrome With Multiple Spontaneous Pregnancies: A Case Report
Authors: Ayman Altalib, Eman AlSulmi, Danah Bokhari, Zaineb Alhalal 2nd, Maram Alismail, Remah Alzayyat
Journal: Cureus (2024)
Keywords: case report, infertility, mosaic, pregnancy, turner syndrome
MeSH terms: Case Reports

Turner syndrome (TS) is an abnormality of the X chromosome affecting females. This genetic defect causes infertility in most cases, but less commonly in patients with the mosaic form of Turner syndrome. In the rare event of a pregnancy, it usually leads to maternal and fetal complications, including miscarriage. In this study, we report a case of mosaic Turner syndrome (45,X/46,XX) in a 34-year-old female who presented to our outpatient clinic with a two-year history of secondary infertility following nine previous spontaneous pregnancies (SP). Her obstetric history showed two successful healthy pregnancies, seven first-trimester miscarriages, one intrauterine fetal demise (IUFD), and one infant death at six months of age. Cases of pregnancy in mosaic Turner syndrome patients are limited and have poor pregnancy outcomes; here, we aim for our case to contribute to the improvement of pregnancy outcomes in such patients.
Utero-ovarian transposition before pelvic radiation in a patient with rectal cancer: a case report and systemic literature review
Authors: Daniela Huber, Colin Simonson, Ian Fournier, Irma Dischl-Antonioni, Francisco Javier Pena Rios, Isaline Francey, Anna Surbone, Yannick Hurni
Journal: Front Surg (2024)
Keywords: fertility preservation, fertility sparing surgery, ovarian transposition, pelvic radiotherapy, rectal cancer, uterine transposition
MeSH terms: Review

Objective:
To describe a case of utero-ovarian transposition (UOT) before pelvic radiation in a patient with rectal cancer and provide a systematic literature review on all reported cases of UOT.
Methods:
We performed a prospective collection and revision of clinical, intraoperative, and postoperative data from a patient who underwent UOT. In addition, a systematic review of the literature available to date on all cases of UOT was realized, and 14 patients from 10 articles were included.
Results:
We reported the case of a 28-year-old nulligravida patient who was diagnosed with a low-grade rectal adenocarcinoma and underwent neoadjuvant chemoradiotherapy, followed by transanal total mesorectal excision (TaTME). Before starting neoadjuvant oncological therapies, the patient underwent laparoscopic UOT. The intervention was performed without complications, and the patient received neoadjuvant oncological treatments as planned. TaTME and uterus repositioning were completed six weeks after the end of radiotherapy. No complications were observed during the first 9 postoperative months. Adequate utero-ovarian perfusion was assessed by Doppler ultrasound, cervicovaginal anastomosis appeared to have healed correctly, and the patient experienced menstrual bleeding. Data from the literature review of all reported cases of UOT were presented and discussed.
Conclusions:
UOT represents a valuable option to preserve fertility in patients requiring pelvic radiotherapy. This study provides additional evidence on the feasibility and safety of performing UOT.
Post-partum cerebral venous sinus thrombosis: A case report
Authors: Shruti Jain, Mehak Bhushan, Vandana Talwar
Journal: Qatar Med J (2024)
Keywords: pregnancy, puerperium, thrombosis
MeSH terms: Case Reports

Introduction:
Cerebral venous sinus thrombosis (CVST) is a rare and life-threatening condition that may be encountered during pregnancy and puerperium. The diagnosis of CVST is a challenge because of its varied presentation.
Case report:
A 28-year-old woman presented with headache, projectile vomiting, and generalized tonic-clonic seizures 10 days after delivery by cesarean section. She had an uneventful antenatal period of 38 weeks of gestation. High clinical suspicion and the availability of magnetic resonance venography helped in making a diagnosis of CVST. She was successfully managed with a low-molecular-weight heparin (LMWH) and anti-epileptic therapy with no residual complications.
Discussion:
Pregnancy induces several prothrombotic changes in the coagulation system that predispose to CVST. These changes persist for six to eight weeks after birth. Infection and cesarean section are the additional risk factors for CVST during puerperium. The symptoms of CVST depend on the sinuses and veins involved, raised intracranial pressure, and the extent of brain parenchymal injury.
Conclusion:
Greater awareness of the disease and the availability of imaging modalities have contributed to the early diagnosis and favorable outcomes in these cases. LMWH is the main stay of treatment in this disease.
A Case Report of Uterine Torsion: An Obstetric Emergency During Pregnancy
Authors: Vidya Gaikwad, Sneha Aramandla, Suhas Gaikwad
Journal: Cureus (2024)
Keywords: fetoplacental, insufficiency, oligohydramnios, uterine torsion, uteroplacental
MeSH terms: Case Reports

Uterine torsion is an exceedingly rare obstetric emergency representing pelvic organ torsion, characterized by the uterus rotating more than 45 degrees around the longitudinal axis. This torsion predominantly occurs at the junction of the cervix and uterine corpus. Albeit the infrequent prevalence, this condition can arise in any reproductive group. Oligohydramnios is defined as an amniotic fluid volume of 2 cm or less in the single deepest vertical pocket. During pregnancy, uterine torsion is known to be associated with severe maternal and perinatal consequences encompassing placental abruption, maternal mortality, and intrauterine fetal demise. Here, we present a specific case of a woman who experienced uterine torsion during pregnancy, leading to complications such as uteroplacental and fetoplacental insufficiency, severe fetal growth restriction, and persistent oligohydramnios throughout the pregnancy.
Case report: Donor-derived CLL-1 chimeric antigen receptor T-cell therapy for relapsed/refractory acute myeloid leukemia bridging to allogeneic hematopoietic stem cell transplantation after remission
Authors: Xiaojuan Miao, Yanrong Shuai, Ying Han, Nan Zhang, Yilan Liu, Hao Yao, Xiao Wang, Guangcui He, Dan Chen, Fangyi Fan, Alex H Chang, Yi Su, Hai Yi
Journal: Front Immunol (2024)
Keywords: c-type lectin-like molecule 1, acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation, donor-derived chimeric antigen receptor t cells, relapsed/refractory
MeSH terms: Hematopoietic Stem Cell Transplantation, Immunotherapy, Adoptive / adverse effects, Immunotherapy, Adoptive / methods, Leukemia, Myeloid, Acute / immunology, Leukemia, Myeloid, Acute / therapy, Transplantation, Homologous, Case Reports, Adult, Female, Graft vs Host Disease / etiology, Humans, Male, Middle Aged, Receptors, Chimeric Antigen / immunology, Remission Induction, Tissue Donors, Transplantation Conditioning / methods, Treatment Outcome, Receptors, Chimeric Antigen

Background:
Explore the efficacy and safety of donor-derived CLL-1 chimeric antigen receptor T-cell therapy (CAR-T) for relapsed/refractory acute myeloid leukemia (R/R AML) bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) after remission.
Case presentation:
An adult R/R AML patient received an infusion of donor-derived CLL-1 CAR-T cells, and the conditioning regimen bridging to allo-HSCT was started immediately after remission on day 11 after CAR-T therapy upon transplantation. Then, routine post-HSCT monitoring of blood counts, bone marrow (BM) morphology, flow cytometry, graft-versus-host disease (GVHD) manifestations, and chimerism status were performed.
Result:
After CAR-T therapy, cytokine release syndrome was grade 1. On day 11 after CAR-T therapy, the BM morphology reached complete remission (CR), and the conditioning regimen bridging to allo-HSCT started. Leukocyte engraftment, complete donor chimerism, and platelet engraftment were observed on days +18, +23, and +26 post-allo-HSCT, respectively. The BM morphology showed CR and flow cytometry turned negative on day +23. The patient is currently at 4 months post-allo-HSCT with BM morphology CR, negative flow cytometry, complete donor chimerism, and no extramedullary relapse/GVHD.
Conclusion:
Donor-derived CLL-1 CAR-T is an effective and safe therapy for R/R AML, and immediate bridging to allo-HSCT after remission may better improve the long-term prognosis of R/R AML.
Early diagnosis of thoracic spinal dural arteriovenous fistula using lumbar magnetic resonance imaging: A case report
Authors: May Pyae Kyaw, Tatsuya Tanaka, Satoshi Anai, Yukinori Takase, Kiku Kamitoko, Hiromu Minagawa, Motohiro Yukitake, Junpei Sasaki, Oya Nagata, Akira Matsuno, Tadatsugu Morimoto
Journal: Clin Case Rep (2024)
Keywords: gait disturbance, intermittent claudication, overlooked case, spinal dural arteriovenous fistula, thoracic vertebrae
MeSH terms: Case Reports

In middle-aged and older men, clinicians often suspect lumbar spine disease when gait is impaired with intermittent claudication, but spinal dural arteriovenous fistula (SDAVF) may be the etiology. An understanding of the key magnetic resonance imaging findings of SDAVF is necessary for early diagnosis, appropriate treatment, and minimization of complications.
Imaging and histopathologic characteristics of typical pancreatic hamartoma: a case report and literature review
Authors: Shunli Liu, Lei Yang, Jie Wu, Xin Lin, Zaixian Zhang
Journal: Front Oncol (2024)
Keywords: computed tomography, imaging - radiology, immunohistochemistry, magnetic resonance imaging, pancreatic hamartoma
MeSH terms: Case Reports

Background:
Pancreatic hamartoma, a rare benign non-neoplastic condition, presents challenges in differentiating from other pancreatic diseases due to its atypical imaging and unreliable biopsy results. In this study, we present a case of pancreatic hamartoma and conduct a comprehensive review of relevant literature to outline its characteristic features, aiming to underscore its clinical relevance and implications.
Case presentation:
A 63-year-old man presented with a pancreatic mass, discovered during evaluation of abdominal pain and distension. Laboratory tests were largely unremarkable. Ultrasound revealed a hypoechoic mass in the head of the pancreas. Subsequent computed tomography and magnetic resonance imaging demonstrated an inhomogeneous mass with a clear boundary in the uncinate process of the pancreas. Furthermore, a distinct delayed enhancement pattern was noted on imaging. Histopathological examination confirmed the diagnosis of pancreatic hamartoma.
Conclusions:
Preoperative diagnosis of pancreatic hamartoma remains challenging. Imaging modalities can play a crucial role in facilitating accurate diagnosis and potentially avoiding unnecessary surgical intervention in patients with this condition.
Pulmonary thromboembolism: a case report and misdiagnosis analysis of a 63-year-old female patient
Authors: Yingli Deng, Jing Lai, Qingmin He
Journal: Front Med (Lausanne) (2024)
Keywords: case report, diagnosis, misdiagnosis, pneumonia, pulmonary thromboembolism
MeSH terms: Case Reports

This paper presents a case of a 63-year-old female patient who was initially misdiagnosed with mycoplasma pneumonia due to symptoms such as chest pain, hemoptysis, and fever, but was later confirmed to have pulmonary thromboembolism (PTE) through further examination. This case highlights the similarities between PTE and pneumonia in terms of symptoms, as well as the complexity of PTE diagnosis. The article provides a detailed description of the patient's medical history, symptoms, examination process, and treatment outcomes. Furthermore, it discusses the possible reasons for the misdiagnosis, including insufficient awareness of PTE among physicians, lack of in-depth investigation into the causes of abnormally elevated D-dimer levels, the non-specific clinical manifestations of PTE, and the concerns of the patient's family regarding pulmonary artery CTA examination. Additionally, the article emphasizes the importance of clinicians in improving their ability to differentiate and diagnose PTE, rationally utilizing clinical examination methods, and ensuring timely diagnosis and treatment of PTE.
Severe ischaemic colitis secondary to microvenular thrombosis in a hypercoagulable patient
Authors: Emily R Moran, Anand Trivedi
Journal: J Surg Case Rep (2024)
Keywords: hypercoagulability, ischaemic colitis, microvenular thrombosis
MeSH terms: Case Reports

A young patient with multifactorial prothrombotic risk factors presented with signs and symptoms of ischaemic colitis, without evidence of bowel hypoperfusion on imaging. She deteriorated with trial of conservative management and required operative management. Intraoperative findings demonstrated severe, confluent large bowel necrosis, sparing the rectum. A total colectomy was performed, with return to intensive care unit due to intraoperative hemodynamic instability. A return to theatre the following day allowed for formation of ileostomy and definitive closure. Histopathological findings of microvenular thrombosis were confirmed. Venous causes of ischaemic colitis present diagnostic challenges due to variable presentation and imaging findings. Microvascular venous thrombosis is likely secondary to multifactorial prothrombotic risk factors including positive autoantibodies and variable compliance with warfarin therapy for aortic value replacement. We present this case of ischemic colitis secondary to an unusual aetiology to emphasize the need to remain clinically suspicious of severe abdominal pain despite relatively benign imaging findings.