OpenMed/multicare-articles huggingface dataset:
Povidone Iodine Disinfection Associated with Hypothyroidism and Potentially Contributing to Prolonged Kidney Failure
Authors: Yasmine Vercammen, Dieter Dauwe, Greet De Vlieger, Sabrina Houthoofd, Lars Desmet, Michael P Casaer
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Objectives:
To report a case of povidone-iodine (PVP-I, Iso-Betadine®) disinfection of lower leg fasciotomy wounds resulting in iodide absorption and possibly contributing to hypothyroidism and prolonged kidney injury.
Design:
Case report. Setting. Pediatric intensive care unit (PICU), university hospital. Patients. A 13-year-old patient presenting with prolonged oligoanuric kidney failure and unexplained primary hypothyroidism three weeks after severe abdominal sepsis with multiple organ dysfunction and major rhabdomyolysis due to bilateral lower leg compartment syndrome, necessitating moderate size fasciotomies, disinfected daily with PVP-I. Interventions. Interruption of PVP-I exposure and initiation of thyroid hormone substitution. Measurements and Main Results. Hypothyroidism was revealed during diagnostic work-up for persistent hypertriglyceridemia. Thyroxine (T4) (4.0 mg/L) and tri-iodothyronine (T3) (64 ng/L) were moderately low, yet thyroid stimulating hormone (TSH) (16.8 mIU/L) was fourfold the maximal normal range value. This pattern, atypical for prolonged critical illness-related hypothyroidism, prompted interruption of PVP-I exposure and initiation of thyroid hormone substitution. Urinary production and creatinine clearance recovered during the following days, and one week later, intermittent renal replacement therapy could be terminated, suggesting that PVP-I toxicity and/or hypothyroidism may have contributed to the persistent renal failure three weeks after resolved septic shock and rhabdomyolysis. Elevated serum and urinary anion gap normalized simultaneously, but this evolution of rather nonspecific indices could be multifactorial.
Conclusion:
PVP-I is a commonly used broad-spectrum antimicrobial agent for prevention and treatment of wound infections. Toxic complications due to PVP-I absorption, after disinfection of extended thermal injuries larger than 20% of the body surface, have been described. In critically ill children, however, toxic effects of PVP-I may occur due to repeated disinfection of less extended wounds. Proposed screening strategies include: monitoring of the volumes of PVP-I applied daily; of the thyroid function, the serum, and/or urinary anion gap and the urinary iodide concentrations. These strategies, however, remain to be validated. This case report should be a wake-up call for daily integration of wound management in the clinical evaluation of critically ill patients.
Accidental intrathecal injection of tranexamic Acid
Authors: Khaled Mahmoud, Amany Ammar
Journal: Case Rep Anesthesiol (2012)
MeSH terms: Case Reports

Tranexamic acid (TXA) is a popular antifibrinolytic drug that is commonly used in patients with bleeding disorder. Major morbidities and mortalities have been reported following inadvertent intrathecal injection of TXA. In this paper, inadvertent intrathecal injection of TXA has resulted from similarities in appearance between TXA and heavy bupivacaine 0.5% ampoules. The patient experienced severe pain in the back and gluteal region upon injection in association with systemic hypertension and tachycardia followed by generalized myoclonic seizures and ventricular fibrillation.
Large Pericardial Cyst Presenting as Acute Cough: A Rare Case Report
Authors: Michael Makar, Gabriel Makar, Kerolos Yousef
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Pericardial cysts are an uncommon cause of mediastinal masses and may be found incidentally on imaging. Symptoms commonly include cough, chest pain, and shortness of breath elucidating a broad differential on examination. Diagnosis is predominantly made using imaging modalities, such as CT, MRI, and CXR with treatment including resection for symptomatic cysts and observation for asymptomatic cysts. Due to a lack of specific signs and symptoms towards identifying pericardial cysts, many are identified at a later stage requiring resection by video-assisted thoracoscopic surgery (VATS). We present the rare case of a patient presenting with a sudden onset cough, shortness of breath, and pleuritic chest pain found to have a large pericardial cyst.
Three novel compound heterozygous IL12RB1 mutations in Chinese patients with Mendelian susceptibility to mycobacterial disease
Authors: Xiaopei Zhou, Weimin Jia, Zhengyi Ni, Ali Wang, Zhenxing Liu, Meiqi Hou, Mi Zhou, Zhongwen Tang, Dazhi Zhang, Lei Li, Tiantian Han, Yang Tan, Geng Luo, Jiarui Wang, Yanling Wu, Xianqin Zhang
Journal: PLoS One (2019)
MeSH terms: Genetic Predisposition to Disease, Heterozygote, Mycobacterium Infections / genetics, Point Mutation, Receptors, Interleukin-12 / genetics, Case Reports, Research Support, Non-U.S. Gov't, Asian People, China, Female, Humans, Infant, Interferon-gamma / genetics, Interferon-gamma / immunology, Male, Mycobacterium Infections / immunology, Receptors, Interleukin-12 / immunology, IFNG protein, human, IL12RB1 protein, human, Receptors, Interleukin-12, Interferon-gamma

Mendelian Susceptibility to Mycobacterial Diseases (MSMD) is a primary immunodeficiency disease (PID) characterized by variable susceptibility to weakly virulent mycobacteria (Bacille Calmette-Guerin, BCG) and various intramacrophagic bacteria, fungi, parasites. Mycobacterial disease generally begins in childhood, more rarely during adolescence and adulthood. The pathogenesis of MSMD is the inherited impaired production of interferon gamma (IFN-γ) or inadequate response to it. Autosomal recessive IL12RB1 deficiency is the most common genetic etiology of MSMD. Here we identified three novel compound heterozygous mutations in IL12RB1 gene (c.635G>A, c.765delG; c.632G>C, c.847C>T; c.64G>A, c.1673insGAGCTTCCTGAG) in three Chinese families with MSMD.
A Case of Acute Life-Threatening Pulmonary Hemorrhage from Synthetic Cannabinoid Abuse
Authors: Muhammad Imtiaz, Biplab Saha, Uzma Sana Ullah, Aditi Saha
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

We report a case of alveolar hemorrhage secondary to inhalation of synthetic cannabinoid. The patient developed hemoptysis and respiratory failure 48 hours after the episode. Alveolar hemorrhage from synthetic cannabinoid use is a rare entity that has been reported only thrice previously. The unique feature of this case was that the initial urine and blood toxicology screens were negative for cannabinoids and the diagnosis was confirmed via detection of serum metabolites of a synthetic cannabinoid.
Comparison of Outcomes after Phacoemulsification with Two Different Corneal Incision Distances Anterior to the Limbus
Authors: Lijun Wang, Lin Zhao, Xiting Yang, Yi Zhang, Dingying Liao, Jianming Wang
Journal: J Ophthalmol (2019)

Purpose:
To compare visual performance and visual quality outcomes after phacoemulsification with two different clear corneal incision (CCI) distances anterior to the limbus in senile cataract patients.
Methods:
Retrospective case series. Patients who had undergone phacoemulsification were divided into two groups according to the CCI distances anterior to the limbus. The CCI distances in group A range from 1 mm to 1.5 mm, while those in group B range from 0.5 mm to 1 mm. The visual acuity, refraction, surgically induced astigmatism (SIA), corneal aberrations, anterior segment parameters, and subjective vision quality were evaluated.
Results:
This study enrolled 54 eyes, with 27 eyes per group. Both groups had significant improvement in postoperative uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) (P < 0.05). There were no statistically significant between-group differences in postoperative UDVA, CDVA, SIA, corneal aberrations, anterior segment parameters, or VF-QOL questionnaire performance (P > 0.05).
Conclusions:
The phacoemulsification with CCI distances ranging from 0.5 mm to 1.5 mm is an effective and safe therapy to senile cataract. The CCI distance anterior to the limbus that ranges from 0.5 mm to 1.5 mm is recommended for routine phacoemulsification.
Case Report: " I got my brain back" A patient's experience with music-induced analgesia for chronic pain
Authors: Roberto E Mercadillo, Eduardo A Garza-Villarreal
Journal: Front Psychol (2023)
Keywords: clinical, music, music-induced analgesia, opioids, pain, phenomenology, therapeutic accompaniment
MeSH terms: Case Reports

Listening to music has progressively been proposed as a complementary alternative for chronic pain; understanding its properties and its neurobiological bases is urgent. We show a phenomenological investigation of a woman who has lived 20 years with chronic pain. The inquiry involved her experience of the context in which she listens to music, the intensity and quality of pain, body mapping, memories, emotions, and cognition. The participant listens to music for different reasons, such as pain and anxiety relief, motivation to exercise, and quality of sleep, but all seem to revolve around different strategies for pain management. Experiences in physiological and cognitive aspects included perceived restorative sleep that may have improved the participant's general wellbeing and improved cognitive and motor performance as well as communication skills. The music enabled the participant not only to relieve pain but also withdrawal effects after discontinuing her opioid-based treatment. These effects may encompass endogenous opioid and dopamine mechanisms involving natural analgesia associated with pleasurable experiences. Future studies could consider phenomenological case studies and therapeutic accompaniment to reorient subjective properties of pain and expand quantitative and qualitative knowledge for more comprehensive reports on music and analgesia.
Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation
Authors: J Y Woo, L Tate, S Roth, A C Eke
Journal: Case Rep Obstet Gynecol (2015)

Introduction. Silent spontaneous rupture of the uterus before term, with extrusion of an intact amniotic sac and delivery of a healthy neonate, with no maternal or neonatal morbidity or mortality is very rare. Very few cases have been reported in literature. Case Presentation. We report a case of silent spontaneous uterine rupture, found during a scheduled repeat cesarean section at 36 weeks of gestation. Patient had history of two prior classical cesarean sections. She underwent cesarean section, with delivery of a healthy male infant. She had a good postoperative recovery and was discharged on postoperative day 3. Conclusion. Silent spontaneous rupture of the uterus before term with extrusion of an intact amniotic sac is rare. A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.
Case report: Prenatal diagnosis of Kagami-Ogata syndrome in a Chinese family
Authors: Junjie Hu, Ying Zhang, Yanmei Yang, Liya Wang, Yixi Sun, Minyue Dong
Journal: Front Genet (2022)
Keywords: kagami–ogata syndrome, temple syndrome, differentially methylated region, imprinting disorder, prenatal diagnosis
MeSH terms: Case Reports

The aim of this work was to explore the genetic cause of the proband (Ⅲ2) presenting with polyhydramnios and gastroschisis. Copy number variation sequencing (CNV-seq), methylation-specific multiplex PCR (MS-PCR), and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) were used to characterize the genetic etiology. CNV-seq revealed a deletion of 732.26 kb at 14q32.2q32.31 in the proband (Ⅲ2) and its mother (Ⅱ2). MS-PCR showed the maternal allele was missing in the proband, while paternal allele was missing in its mother. MS-MLPA showed deletion of the DLK1, MEG3, MIR380, and RTL1 genes of both the proband and its mother. MEG3 imprinting gene methylation increased in the proband, while decreased in its mother. It was indicated that a maternally transmitted deletion was responsible for Kagami-Ogata syndrome in the proband (Ⅲ2), and the de novo paternal deletion resulted in Temple syndrome in the mother (Ⅱ2). Prenatal diagnosis was provided at 17+3 weeks of pregnancy on the mother's fourth pregnancy (Ⅲ4). Fortunately, the karyotype and single-nucleotide polymorphism array (SNP array) results were normal. The current investigation provided the detection methods for imprinted gene diseases, expanded the phenotype spectrum of the disease, and obtained the insight into the diagnosis, prenatal diagnosis, and genetic counseling of the disease.
Case Report: Persistent erectile dysfunction in a man with prolactinoma
Authors: Justin Badal, Ranjith Ramasamy, Tariq Hakky, Aravind Chandrashekar, Larry Lipshultz
Journal: F1000Res (2015)
Keywords: prolactin, sexual dysfunction

Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma. Patients who have had both prolactinemia and erectile dysfunction have been reported in the literature, but we find no report of a patient with persistent erectile dysfunction in the setting of testosterone supplementation and persistent hyperprolactinemia refractory to treatment. This case provides evidence supporting the idea that suppression of erectile function occurs in both the central and peripheral nervous systems independent of the hypothalamic-pituitary-gonadal axis.
A case report of sudden cardiac arrest and torsade de pointes induced by the second-generation tyrosine kinase inhibitor dasatinib combined with fluconazole
Authors: Yuting Yuan, Chunjian Wang, Hongying Yao
Journal: Front Cardiovasc Med (2023)
Keywords: case report, dasatinib, drug-induced long qt syndrome, fluconazole, sudden cardiac arrest, torsade de pointes, tyrosine kinase inhibitor
MeSH terms: Case Reports

A-41-year-old man diagnosed with acute myeloid leukemia (AML) survived dasatinib + fluconazole drug-induced long QT syndrome, sudden cardiac arrest, and torsade de pointes. Drug features and interaction jointly contributed to the whole process. Therefore, appropriate attention to drug interaction and close ECG monitoring are highly recommended for hospitalized patients, especially for those undergoing multi-drug regimens.
Septic arthritis of the hip joint due to Bacteroides fragilis in a paraplegic patient
Authors: Anna Shalman, Asaf Acker, Alexander Shalman, Dmitry Frank, Abraham Borer, Leonid Koyfman, Vladimir Kotlovker, Lisa Saidel-Odes, Ohad Gabay, Moti Klein, Evgeni Brotfain
Journal: Access Microbiol (2019)
Keywords: bacteroides fragilis, critical care, native joint, septic arthritis
MeSH terms: Case Reports

Septic arthritis of native joints is a potentially life-threatening disease. The most frequently isolated pathogens are Gram-positive cocci. Bacteroides fragilis is a rare pathogen in joint infections and is usually associated with immunocompromised and debilitated patients. Most cases of B. fragilis joint infection are related to skin or local perineal infections or are secondary to B. fragilis bacteraemia from another source, for example from the gastrointestinal tract. We present a clinical case of B. fragilis septic arthritis involving a native hip joint in a previously healthy paraplegic patient.
Treatment of abdominal aortic pseudoaneurysm caused by brucellosis with endovascular aneurysm repair
Authors: Xiao Li, Qilong Wang, Yang Zhang, Xiwei Sun, Hang Yin, Hua Zhang, Sean X Luo, Zhongying Wang, Qi Yu, Zhiming Chen, Zhihua Cheng
Journal: Front Bioeng Biotechnol (2023)
Keywords: abdominal aortic pseudoaneurysm, brucellosis, digital subtraction angiography, endovascular aneurysm repair, peripheral arterial disease
MeSH terms: Case Reports

Peripheral vascular disease caused by brucellosis is rarely seen around the world; thus, it is easily ignored by patients and doctors, leading to a lack of corresponding screening and delayed comprehensive treatment. Currently, there is no standard or guideline for diagnosing and treating peripheral arterial disease caused by brucellosis. From June 2021 to December 2022, four cases of abdominal aortic pseudoaneurysm caused by brucellosis disease were treated with endovascular aneurysm repair This study reported treatment results as follows and reviewed the incidence, treatment, and prognosis of abdominal aortic pseudoaneurysm caused by brucellosis.
Consecutive bilateral breast reconstruction using different autologous flaps: can symmetrical results still be achieved? A case report
Authors: Antonios Tsimponis, Dimitrios Dionyssiou, Spyros Miliaras, Efterpi Demiri
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: autologous breast reconstruction, deep inferior epigastric perforator flap, fat-augmented latissimus dorsi flap
MeSH terms: Case Reports

We report a 60-year-old patient who underwent bilateral mastectomy at different times, followed by immediate autologous reconstruction with different flaps: deep-inferior epigastric-perforator flap on one breast, and fat-augmented latissimus dorsi on the contralateral side. At 20-month follow-up, good symmetry was recorded; patient-reported outcome measurements revealed high satisfaction scores.
A Case of Pediatric Sternal Fracture Diagnosed by POCUS
Authors: Takaaki Mori, Sung Shin Teng
Journal: POCUS J (2023)
Keywords: children, point-of-care ultrasound, sternal fracture
MeSH terms: Case Reports

A previously healthy, 4-year-old boy visited our emergency department due to chest pain after a fall from a skate scooter. Physical examination revealed tenderness over the sternal body. Point of care ultrasound (POCUS) of the sternum demonstrated a discontinuation of a hyperechoic structure of the sternal cortex, suggesting a sternal fracture. POCUS did not detect intraperitoneal fluid, pericardiac effusion, or pneumothorax. Plain radiograph confirmed the diagnosis of isolated sternal fracture and the patient was discharged with conservative treatment. POCUS was useful not only in diagnosing a sternal fracture but also to rule out concurrent injuries.
Aortic Cannulation around Grade 5 Aortic Arch Atheroma Utilizing Transesophageal Echocardiography
Authors: Trey W Vanek, Jeremiah Hayanga, Matthew Ellison, Jeffrey Puette, Lawrence Wei, Heather K Hayanga
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

A 61-year-old male with severe aortic valve stenosis was scheduled for a minimally invasive bioprosthetic aortic valve replacement. Intraoperative transesophageal echocardiography (TEE) showed a unicuspid aortic valve and extensive aortic atheromatous disease. A large atheroma with mobile components existed near the distal aortic arch. A 17-French aortic cannula was successfully placed using TEE guidance with the tip proximal to the mobile atheroma to avoid inadvertent disruption and subsequent embolic sequelae. The patient had no evidence of perioperative stroke or other complications postoperatively. This case demonstrates one strategy to manage severe atheromatous disease intraoperatively. We also review additional management options.
A Melanoma Lymph Node Metastasis with a Donor-Patient Hybrid Genome following Bone Marrow Transplantation: A Second Case of Leucocyte-Tumor Cell Hybridization in Cancer Metastasis
Authors: Greggory S LaBerge, Eric Duvall, Zachary Grasmick, Kay Haedicke, John Pawelek
Journal: PLoS One (2017)
MeSH terms: Genome, Human, Leukocytes / metabolism, Lymph Nodes / pathology, Melanoma / genetics, Melanoma / pathology, Transplantation Chimera / genetics, Case Reports, Biomarkers, Bone Marrow Transplantation, Humans, Leukocytes / pathology, Male, Melanoma / metabolism, Melanoma / therapy, Microsatellite Repeats, Middle Aged, Neoplasm Metastasis, S100 Proteins / metabolism, Sequence Analysis, DNA, Tissue Donors, Biomarkers, S100 Proteins

Background:
Metastatic disease is the principal cause of mortality in cancer, yet the underlying mechanisms are not fully understood. Macrophage-cancer cell fusion as a cause of metastasis was proposed more than a century ago by German pathologist Prof. Otto Aichel. Since then this theory has been confirmed in numerous animal studies and recently in a patient with metastatic melanoma.
Methods:
Here we analyzed tumor DNA from a 51-year-old man who, 8 years following an allogeneic BMT from his brother for treatment of chronic myelogenous leukemia (CML), developed a nodular malignant melanoma on the upper back with spread to an axillary sentinal lymph node. We used laser microdissection to isolate FFPE tumor cells free of leucocytes. They were genotyped using forensic short tandem repeat (STR) length-polymorphisms to distinguish donor and patient genomes. Tumor and pre-transplant blood lymphocyte DNAs were analyzed for donor and patient alleles at 15 autosomal STR loci and the sex chromosomes.
Results:
DNA analysis of the primary melanoma and the nodal metastasis exhibit alleles at each STR locus that are consistent with both the patient and donor. The doses vary between these samples indicative of the relative amounts of genomic DNA derived from the patient and donor.
Conclusion:
The evidence supports fusion and hybridization between donor and patient cells as the initiator of metastasis in this patient. That this phenomenon has now been seen in a second case suggests that fusion is likely to play a significant role for melanoma and other solid tumor metastasis, perhaps leading to new avenues of treatment for this most problematic disease.
Small Duplication of HPRT 1 Gene May Be Causative For Lesh-Nyhan Disease in Iranian Patients
Authors: Razieh Boroujerdi, Mohsen Shariati, Hosein Naddafnia, Hojatolah Rezaei
Journal: Iran J Child Neurol (2015)
Keywords: hprt gene, lesch-nyhan syndrome, prenatal diagnosis, purine metabolism
MeSH terms: Case Reports

Deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) is a rare inborn error of purine metabolism and is characterized by uric acid overproduction along with a variety of neurological manifestations that depend on a degree of the enzymatic deficiency. Inheritance of HPRT deficiency is X-linked recessive; thus, males are generally more affected and heterozygous females are carriers (usually asymptomatic). Human HPRT is encoded by a single structural gene on the long arm of the X chromosome at Xq26. More than 300 mutations in the HPRT1 gene have been detected. Diagnosis can be based on clinical and biochemical findings as well as enzymatic and molecular testing. Molecular diagnosis is the best way as it allows for faster and more accurate carrier and prenatal diagnosis. In this report, a new small duplication in the HPRT1 gene was found by sequencing, which has yet to be reported.
Case Report: Spinal Stabilization Surgery Using a Novel Custom-Made Titanium Fixation System for the Spinal Instability Caused by Vertebral Malformation in a Dog
Authors: Shintaro Kimura, Kohei Nakata, Yukiko Nakano, Yuta Nozue, Naoyuki Konno, Taku Sugawara, Sadatoshi Maeda, Hiroaki Kamishina
Journal: Front Vet Sci (2021)
Keywords: custom-made implant, dog, spinal stabilization, surgical treatment, vertebral malformation
MeSH terms: Case Reports

A 2-year-old Maltese was presented with wobbly gait of the pelvic limbs. Based on imaging examinations, a diagnosis of congenital malformation at T5-T8 and severe kyphosis causing spinal cord compression at T6-T7 was made. Dorsal laminectomy and stabilization of T6 and T7 vertebrae were performed. As the size of the vertebrae was small and they were severely deformed, novel custom-made titanium implants were used for spinal stabilization. Clinical signs were resolved 2 weeks after surgery. Although radiographic examination 373 days after surgery showed slight loosening of implants, post-operative course remained uneventful. This report describes the use of novel custom-made titanium implants for spinal fixation surgery in a dog.