OpenMed/multicare-articles huggingface dataset:
Case report: A novel occurrence of persistent left cranial vena cava coexisting with polycystic kidney disease in a cat
Authors: Ye-Eun Cha, Woong-Bin Ro, Seung-Ji Song, Mi-Kyung Lee, Min-Hee Kang, Hee-Myung Park
Journal: Front Vet Sci (2023)
Keywords: chronic kidney disease, coronary sinus, feline, persistent left cranial vena cava, polycystic kidney disease, saline contrast echocardiography
MeSH terms: Case Reports

A 7-year-old castrated male Munchkin cat was presented with anorexia. This cat had been diagnosed with chronic kidney disease due to polycystic kidney disease. Tachycardia with a systolic murmur (grade III/VI) was auscultated and for further diagnosis, echocardiography was performed. Based on echocardiography, persistent left cranial vena cava (PLCVC) was suspected due to enlargement of the coronary sinus and confirmed by saline contrast echocardiography. The dilated coronary sinus compressed the left atrium, and left ventricular hypertrophy with the systolic anterior motion of the mitral valve, aortic regurgitation, and mitral regurgitation were identified. After medical management using atenolol, left atrial function and other hemodynamics of the heart were improved, including the disappearance of regurgitation and normalization of left ventricular wall thickness. This case report describes the echocardiographic characteristics, diagnostic procedures, and disease progression in a cat with PLCVC after medical management using atenolol. Additionally, this is the first report of a cat with PLCVC, coexisting with polycystic kidney disease.
Cardiac Myxoid Spindle Cell Tumor in a Neonate
Authors: Reza Abbaszadeh, Fatemeh Naderi, Amir Hossein Jalali, Yaser Toloueitabar
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Introduction: Different subtypes of cardiac tumors containing spindle cells have been described as cardiac sarcoma. However, benign types have not been reported so far. We described a neonate with progressive respiratory distress who had a PDA and was finally diagnosed with a right atrial spindle cell tumor. Case Presentation: The patient was a neonate referred with respiratory distress and sepsis. The initial echocardiography demonstrated a small atrial septal defect, patent ductus arteriosus, and a heterogeneous rounded right atrial mass lesion. Pathologic examination confirmed the right atrial myxoid spindle cell tumor without local invasion. Successful mass resection was performed, and follow-up echocardiography revealed normal cardiac structure and function. Conclusion: In infants with manifestations of possible cardiac anomalies, it is necessary to consider other pathologies, such as neoplastic processes. Spindle cell detection in pathology is not ominous all the time, and there are benign subtypes with favorable outcomes after successful surgical resection.
Pop Goes the Lung: Bilateral Pneumothoraces Due to Delayed Pneumatocele Rupture in Coronavirus Disease 2019 (COVID-19)
Authors: Bashar Khiatah, Amanda Frugoli, Ralph Akl, Allan Wagner, Brian Utz, Robert Bernstein
Journal: Cureus (2024)
Keywords: bilateral spontaneous pneumothorax, covid-19, covid-19 complication, covid-associated pneumothorax, pneumatocele
MeSH terms: Case Reports

Worldwide medical and scientific communities are focusing on further understanding coronavirus disease 2019 (COVID-19) complications and its long-term impact on survivors. Pneumatocele cases are being reported more as a consequence of this virus and a cause of pneumothorax in certain patients. In this case vignette, we present a previously healthy male with COVID-19 symptoms who required hospitalization for hypoxia and who required readmission for bilateral pneumothorax from the delayed rupture of pneumatoceles. We describe this rare pathology and provide hypotheses for possible etiologies.
Anaesthetic Management of Distal Penile Hypospadias in a G6PD-Deficient Adolescent: Subarachnoid Block as a Safe Alternative
Authors: Inayat Garg, Gopal Jalwal, Jyoti Kanwat, Soumya Murmu
Journal: Cureus (2024)
Keywords: antioxidant, dexmedetomidine, glucose 6 phosphate dehydrogenase (g6pd), hemolysis, subarachanoid block (sab)
MeSH terms: Case Reports

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common X-linked recessive red blood cell disease in humans. The highest prevalence of G6PD deficiency is reported to be in Africa, Southern Europe, the Middle East, Southeast Asia, and the islands of the Central and South Pacific. G6PD deficiency causes acute hemolysis upon exposure to oxidative stress. Various stress factors that can cause hemolysis include infections, fever, sepsis, various foods such as fava beans, and various medications. In this report, we describe the case of a 13-year-old child who was diagnosed with G6PD deficiency in childhood but did not experience typical complications, such as hemolysis or jaundice. This child underwent Mathieu's flip-flap surgery for the treatment of distal penile hypospadias under spinal anesthesia and underwent the procedure uneventfully, with no hemolytic complications, malignant hyperthermia, or methemoglobinemia. Therefore, the main goals of our anesthesia management are to avoid various agents that cause hemolysis, use agents with antioxidant properties, reduce the stress of surgery through appropriate pain management, and monitor for signs of hemolysis. Therefore, in our case, subarachnoid blockade was found to be a safe and effective anesthetic technique compared with general anesthesia in the treatment of children with G6PD deficiency. Dexmedetomidine has antioxidant properties, maintains upper respiratory tract patency, and has sedative effect. Therefore, in our case, it was administered intravenously for perioperative management.
Case Report: The many faces of bullous pemphigoid
Authors: Laura Rechtien, Lukas Sollfrank, Yannick Foerster, Carola Berking, Michael Sticherling
Journal: Front Immunol (2023)
Keywords: covid-19 vaccination, bullous autoimmune disease, bullous pemphigoid, juvenile pemphigoid, pemphigoid gestationis
MeSH terms: Pemphigoid, Bullous, Skin Diseases, Vesiculobullous, Case Reports, Aged, Autoantibodies, Blister, Female, Humans, Pregnancy, Pruritus, Autoantibodies

The pemphigoid group comprises a number of bullous skin diseases with autoantibodies against different constituents of the basement membrane zone that result in subepidermal detachment and clinically characteristic tense blisters, erosions, urticarial erythema, and itching. Apart from the most frequent type of bullous pemphigoid with antibodies against BP180, which is found predominantly in elderly patients, the disease may present at other ages and different pathogenic conditions. Here, four cases are presented of young age (3 months and 25, 34, and 46 years) and in association with vaccination, pregnancy, or metastatic cancer. Though anti-BP180 was found in all cases, a different pathogenic background may be found in any of them, resulting in characteristic clinical manifestation, yet demanding specifically adapted therapeutic approaches.
Average Volume-assured Pressure Support as Rescue Therapy after CPAP Failure in Pediatric Obstructive Sleep Apnea: A Retrospective Case Series Study
Authors: Victor T Peng, Nauras Hwig, Anayansi Lasso-Pirot, Amal Isaiah, Montserrat Diaz-Abad
Journal: Open Respir Med J (2023)
Keywords: avaps, continuous positive airway pressure, noninvasive ventilation, obstructive sleep apnea, pediatric, polysomnography, treatment

Background:
Continuous positive airway pressure (CPAP) is frequently prescribed for patients with residual obstructive sleep apnea (OSA) following adenotonsillectomy.
Objectives:
The goal was to examine the efficacy of noninvasive ventilation with average volume-assured pressure support (AVAPS) as a potential option for children with failed CPAP titration.
Methods:
In a single-center retrospective study, we included children aged 1-17 years, with polysomnographically confirmed OSA who underwent AVAPS titration following failed CPAP titration. In addition to describing the clinical characteristics of the included patients, we compared polysomnographic parameters before and after AVAPS.
Results:
Nine patients met the inclusion criteria; out of them, 8 (89%) were males with an age range of 6.7 ± 3.9 years and a body mass index percentile of 81.0 ± 28.9. Reasons for failed CPAP titration were: 3 (33%) patients due to inability to control apnea-hypopnea index (AHI), 3 (33%) patients due to sleep-related hypoventilation, 2 (22%) patients due to treatment-emergent central sleep apnea, and 1 (11%) patient due to intolerance to CPAP. AVAPS resulted in a greater reduction in AHI than CPAP (reduction following CPAP = 24.6 ± 29.3, reduction following AVAPS = 42.5 ± 37.6, p = 0.008). All patients had resolution of the problems which caused CPAP failure.
Conclusion:
In this case a series of children with OSA and with failed CPAP titration, AVAPS resulted in a greater reduction in AHI compared with CPAP as well as resolution of the problems which caused CPAP failure.
The Discrepancy of ANA and Compartment Bead Patterns Suggestive of a Neuropsychiatry Systemic Lupus Erythematosus (NPSLE)
Authors: Munawaroh Fitriah, Lita Diah Rahmawati, Indah Adhita Wulanda, Hani Susianti, Betty Agustina Tambunan
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Neuropsychiatric systemic lupus erythematosus (NPSLE) exhibits neurological and psychiatric manifestations in systemic lupus erythematosus (SLE) patients, which NPSLE diagnosis can be challenging for rheumatologists. An Indonesian female, 44 years old, complained of two times seizures with 10-min duration, which during seizures were stiff, eyes rolled up, foaming at the mouth, wet the bed, and fainting afterward. The patient also has a history of SLE and received cyclophosphamide therapy 5 years ago. Her clinical condition showed facial and lingual palsy, with central type on the right. Antinuclear antibody indirect immunofluorescence (ANA IF) positive using cytobead ANA with a homogenous pattern and cytoplasmic speckled titer 1/80. Confirmation beads showed positive of dsDNA only. ANA profile showed positive antinucleosome, antihistone, and AMA-M2, and also increased anticardiolipin antibody that supports the diagnosis of NPSLE. The difference in the pattern of ANA IF with confirmation beads suggests the presence of other autoantibodies in NPSLE.
Uncovering a New Family Cluster of Gaucher Disease: A Case Report
Authors: Ana Carvoeiro, Miguel Costa, Joana Silva, Paula Felgueiras, Diana Guerra
Journal: Cureus (2024)
Keywords: cytopenias, deficiency in glucocerebrosidase, enzyme replacement therapy, gaucher disease, hepatosplenomegaly, lysosomal storage disorder
MeSH terms: Case Reports

Gaucher disease (GD) is a recessive autosomal lysosomal storage disorder caused by a deficiency in glucocerebrosidase, leading to the accumulation of undigested glycolipids in the lysosomes of monocytes and macrophages. Patients with GD exhibit a spectrum of phenotypic heterogeneity and are broadly classified into three subtypes. Type 1 is the most common and is not associated with neurological damage, while types 2 and 3 are more severe, presenting with acute neuropathic and subacute neuropathic symptoms, respectively. A thorough accurate initial multisystemic assessment is crucial for evaluating the damage to all potentially affected organs and determining the disease burden. This case report highlights the intricacies of GD type 1 by providing a thorough exploration of the clinical presentation and showcasing valuable insights into the unique manifestations of the disease. The key feature was his individual and family medical history, which allowed the identification and treatment of another case within the community.
A rare case of Bacillus subtilis variant natto-induced persistent bacteremia with liver and splenic abscesses in an immunocompetent patient
Authors: Tetsuro Amemiya, Kiyofumi Ohkusu, Miku Murayama, Tomokiyo Yamamoto, Naoya Itoh
Journal: IDCases (2024)
Keywords: bacillus subtilis, bacillus subtilis variant natto, immunocompetent, persistent bacteremia
MeSH terms: Case Reports

Bacillus subtilis var. natto, a low-pathogenic bacterium used in the traditional Japanese food "natto" (fermented soybeans), has rarely been reported as a pathogen of infectious diseases in humans. Herein, we report the first case of persistent bacteremia caused by B. subtilis var. natto in an immunocompetent patient without any gastrointestinal involvement. A 53-year-old Japanese woman who had been consuming natto every day was admitted to our hospital with complaints of fever and chills. B. subtilis was isolated from blood cultures collected during the initial visit. Abdominal contrast-enhanced computed tomography (CT) showed multiple low-absorption areas in the liver and spleen. Treatment commenced with vancomycin; however, Bacillus sp. was re-detected in the blood culture on day 4 after treatment initiation. The blood culture on day 8 was negative. Subsequently, the treatment was switched to ampicillin-sulbactam and oral amoxicillin-clavulanic acid, and the patient recovered after 28 days of treatment from the time the blood cultures became negative. Contrast-enhanced CT of the abdomen at the end of treatment showed that the multiple low-absorption areas in the liver and spleen had disappeared. Later, the variant of the bacteria was identified as B. subtilis var. natto by DNA analysis. B. subtilis var. subtilis and B. subtilis var. natto cannot be distinguished using matrix-assisted laser desorption/ionization-time of flight mass spectrometry or 16S rRNA analysis. Biotin auxotrophy of B. subtilis var. natto is used to distinguish between the two variants.
Incidental diagnosis of intestinal perforation on a 99mTc DTPA renogram
Authors: Awiral Saxena, Manjit Sarma, P Shanmuga Sundaram, Padma Subramanyam, Anwin Joseph Kavanal
Journal: Asia Ocean J Nucl Med Biol (2024)
MeSH terms: Case Reports

Perforation of the bowel can be a life-threatening condition and is usually clinically diagnosed when a patient presents with such features as severe abdominal pain, tenderness, and tachycardia. Bowel perforation may be corroborated by various conventional imaging modalities, including X-ray, ultrasonography, computed tomography, and magnetic resonance imaging. Nuclear medicine imaging modalities seldom have a role to play in these settings. Rarely diagnosis of perforation may be missed if it is concealed and does not present with the usual signs. Mostly the perforation will eventually be diagnosed if they develop signs and symptoms and is taken up for an exploratory laparotomy. A delay in diagnosis can later lead to significant patient morbidity or even mortality. This report describes a case where possible intestinal perforation was suspected on a 99mTc-DTPA renogram in a postoperative patient with significant urine leak, the presence of which was confirmed intraoperatively. To our knowledge, this was the first such case in the literature.
Case report: A germline CHEK1 c.613 + 2T>C leads to a splicing error in a family with multiple cancer patients
Authors: Jun Qian, Min Peng, Yanan Li, Wei Liu, Xinwei Zou, Huafei Chen, Sujuan Zhou, Sheng Xiao, Jinhua Zhou
Journal: Front Oncol (2024)
Keywords: chek1, germline mutation, inherited cancer, ovarian cancer, splicing error
MeSH terms: Case Reports

Background:
Genome instability plays a crucial role in promoting tumor development. Germline mutations in genes responsible for DNA repair are often associated with familial cancer syndromes. A noticeable exception is the CHEK1 gene. Despite its well-established role in homologous recombination, germline mutations in CHEK1 are rarely reported.
Case presentation:
In this report, we present a patient diagnosed with ovarian clear cell carcinoma who has a family history of cancer. Her relatives include a grandfather with esophageal cancer, a father with gastric cancer, and an uncle with a brain tumor. The patient carried a typical genomic profile of clear cell carcinoma including mutations in KRAS, PPP2R1A, and PIK3R1. Importantly, her paired peripheral blood cells harbored a germline CHEK1 mutation, CHEK1 exon 6 c.613 + 2T>C, which was also found in her father. Unfortunately, the CHEK1 status of her grandfather and uncle remains unknown due to the unavailability of their specimens. Further evaluation via RT-PCR confirmed a splicing error in the CHEK1 gene, resulting in truncation at the kinase domain region, indicative of a loss-of-function mutation.
Conclusion:
This case highlights a rare germline CHEK1 mutation within a family with a history of cancer. The confirmed splicing error at the mRNA level underscores the functional consequences of this mutation. Documenting such cases is vital for future evaluation of inheritance patterns, clinical penetrance of the mutation, and its association with specific cancer types.
XEN45 Gel Stent Combined with Healaflow Injectable Viscoelastic Implant
Authors: Eloy Villarreal, Eran Berkowitz, Beatrice Tiosano
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Purpose:
To introduce a potential solution for failed glaucoma surgeries by proposing an optional surgical procedure in conjunction with the use of Healaflow (Anteis S.A., Geneva, Switzerland) as a spacer, which may potentially reduce the failure rate. Case Presentation. We present the outcomes of a surgical procedure involving the inferonasal implantation of an ab interno XEN gel stent (Allergan, Dublin, Ireland) in a 74-year-old male patient who was experiencing uncontrolled advanced glaucoma in his left eye. It is important to note that the patient had previously undergone several glaucoma surgeries and procedures in the same eye. During this particular procedure, we utilized Healaflow as a spacer by implanting the stent within a subconjunctival Healaflow "bubble." At 6 months postoperatively, intraocular pressure remained on target. There was no need for additional topical medications, and no change in visual acuity was observed.
Conclusion:
For patients with a history of unsuccessful glaucoma surgeries and who are unsuitable candidates for tube shunt procedures or transscleral diode cyclophotocoagulation, an alternative option involves implanting the XEN45 stent in the inferior nasal region in conjunction with the use of subconjunctival Healaflow. This combined approach may provide a potential solution for managing glaucoma in these patients.
Does adjunctive hemoadsorption provide benefit in the management of ischemia-reperfusion syndrome following near-drowning? A case report
Authors: Pedja Kovacevic, Sasa Dragic, Milka Jandric, Danica Momcicevic, Vedrana Malesevic, Tijana Kovacevic, Marijana Matejic-Spasic, Tanja Knezevic, Biljana Zlojutro
Journal: Front Med (Lausanne) (2024)
Keywords: cytosorb, ecmo, case report, drowning, hemoadsorption, ischemia–reperfusion injury, near-drowning
MeSH terms: Case Reports

Drowning remains a significant global health concern, claiming over 300,000 lives annually, with a disproportionate impact on young individuals in low-and middle-income countries. Conventional mechanical ventilation, while common, falls short in addressing the hypoxemia and hypercapnia often observed in severe near-drowning cases. Veno-venous extracorporeal membrane oxygenation (vvECMO) emerges as a critical intervention for cardiopulmonary failure post-drowning. This case report delves into the pivotal role of ischemia-reperfusion injury (IRI) in a near-drowning-related pathology. Following the initial insult, reoxygenation exacerbates the inflammatory cascade, resulting in a surge of pro-inflammatory mediators. In this context, CytoSorb®, a hemoadsorption cartridge, demonstrates promise by effectively removing these mediators from circulation. This report outlines its application in a critically ill adolescent patient who experienced near-drowning, presenting a compelling case for CytoSorb as an adjunctive therapy in managing IRI-induced hyperinflammation.
Nonbacterial Thrombotic Endocarditis of Bioprosthetic Aortic Valve Presenting as Cardioembolic Stroke in a Patient without Predisposing Systemic Disease
Authors: Samuel J White
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Nonbacterial thrombotic endocarditis (NBTE) describes a cluster of noninfectious heart valve lesions and is histologically characterised by the presence of sterile platelet and fibrin-rich aggregates. Risk factors include hypercoagulable states such as active malignancy, autoimmune disorders, and prothrombotic haematological conditions. NBTE involving bioprosthetic heart valves is exceedingly rare. We present a case of a 73-year-old man with a bioprosthetic aortic valve and no NBTE risk factors who developed right-sided homonymous hemianopia during an admission for decompensated congestive cardiac failure. After detailed clinical work-up including brain MRI, the man was diagnosed with acute ischemic cardioembolic stroke involving the left posterior cerebral artery territory. He subsequently underwent successful bioprosthetic aortic valve replacement with histologic examination of the explant supporting diagnosis of NBTE. Evidence of new neurological deficit or disturbance in patients with prosthetic heart valves should prompt investigation for cardioembolic stroke. Whilst rare, NBTE should be considered as a differential diagnosis for cardioembolic stroke, even in patients without predisposing systemic disease.
The Shehata technique for undescended testes that cannot be brought into the scrotum in one operation-a case series and meta-analysis
Authors: Zhenying Lin, Zhongjing Yu, Huanyuan Li, Letu Wu Ri Ni, Baoxin Zhang
Journal: Front Pediatr (2024)
Keywords: fowler–stephens orchiopexy, shehata technique, orchiopexy, testicular atrophy, undescended testis

Background:
Fowler-Stephens orchiopexy is commonly used for testes that cannot be brought into the scrotum in one operation. However, this surgical technique may result in a higher rate of testicular atrophy postoperatively.
Methods:
During the period between 2019 and 2023, we analyzed the cases of 20 patients in whom the Shehata technique was applied for testes that could not be brought into the scrotum in one operation, and we conducted a meta-analysis to explore the incidence of testicular atrophy vis-à-vis the Shehata technique and Fowler-Stephens orchiopexy.
Results:
The average age of the 20 patients was 3.78 (0.76-11.42) years. The blood supply to the testes was satisfactory, with the absence of atrophy, and the testes could be brought into the scrotum in stage II surgery. A postoperative reexamination with ultrasound revealed that the testes were securely positioned within the scrotum, with good blood supply and no atrophy, which was in contrast to their condition before the operation. The volume of the testes postoperatively was significantly greater than that of the preoperative testes (p = 0.009). There were no statistically significant differences in the growth rate of volume of the testes between the surgically treated side and the contralateral side (p = 0.25). The meta-analysis showed that the Shehata technique resulted in a lower incidence of testicular atrophy compared with Fowler-Stephens orchiopexy (p = 0.01).
Conclusions:
The Shehata technique preserves the main vessels of the testes with a lower incidence of testicular atrophy, which may be a valid and safe alternative to the Fowler-Stephens technique.