OpenMed/multicare-articles huggingface dataset:
Obstructive Hydrocephalus and Cardiomyopathy Secondary to Disseminated Protothecosis in a Boxer Dog
Authors: Anna Tauro, John Macri, Chris Gaudette, Christopher L Mariani, Bonnie Brenseke
Journal: Case Rep Vet Med (2024)
Keywords: mri, prototheca, brain, culture, cytology, dog, formalin-fixed paraffin-embedded tissues, heart, histology, panfungal pcr
MeSH terms: Case Reports

Canine protothecosis is a rare disease caused by saprophytic unicellular achlorophyllous aerobic algae that are ubiquitous in the environment. We report a novel case of neurological and cardiological manifestations associated with disseminated protothecosis. An adult spayed female Boxer dog was presented with a 1-week history of anorexia, progressive central vestibular signs, and a Grade III/VI systolic heart murmur. Magnetic resonance (MR) imaging revealed obstructive hydrocephalus at the level of the mesencephalic aqueduct, while echocardiography and elevated troponin levels suggested an infiltrative cardiomyopathy. No obvious cause was identified. Cerebrospinal fluid (CSF) collection was not performed due to associated procedural risks. Despite receiving symptomatic treatment and maintaining stability for 3 weeks, the dog eventually suffered cardiorespiratory arrest. Postmortem examination revealed disseminated protothecosis, predominantly affecting the heart and brain. We recommend that in cases where the cause of obstructive hydrocephalus is unclear, especially when CSF collection is not feasible, a comprehensive diagnostic method should be implemented. This includes meticulous investigations to identify infected tissues, followed by sampling and performing cytology/histology and culture tests to confirm the presence of the algal organism. Early diagnosis may allow early treatment, although long-term prognosis remains largely unfavorable due to the absence of effective treatments.
Ileo-Ileal Intussusception Caused by a Meckel's Diverticulum With Ectopic Pancreatic Tissue: A Case Report
Authors: Julio A Palma Zapata, Alondra E Llamas Domínguez, Zhenia L Fernández Álvarez, Juliana Palma Zapata
Journal: Cureus (2024)
Keywords: ectopic pancreas, intestinal obstruction, intususcepción, meckel's diverticulum, meckel's diverticulum complications
MeSH terms: Case Reports

A Meckel's diverticulum (MD) is an embryonic remnant of the omphalomesenteric duct. Although most MDs are usually asymptomatic, pediatric patients tend to present serious complications more frequently (4-25% of cases), mainly in digestive tract bleeding, intestinal obstruction, and perforation, which have a high potential to compromise the patient's life. An ectopic pancreas (EP) is pancreatic tissue found outside the pancreas, usually in the stomach, duodenum, and jejunum. It is typically asymptomatic but can increase the risk of complications in the MD. A clinical case of a female infant with an MD complicated with bleeding and ileo-ileal intussusception is presented, in which the histopathological finding of type 1 ectopic pancreatic tissue was also found based on the Heinrich classification, being an entity uncommon in our environment. An EP arising within an MD is infrequent, requiring clinical attention and timely preoperative diagnosis to prevent and treat associated severe complications. This continues to be a superior challenge for the clinician and requires a multidisciplinary team for comprehensive treatment.
Rapid progression from complete molar pregnancy to post-molar gestational trophoblastic neoplasia: a rare case report and literature review
Authors: Jing Qian, Kaoma Gracious, Liping Sun
Journal: Front Oncol (2023)
Keywords: complete hydatidiform mole, gestational trophoblastic disease, gestational trophoblastic tumor, hydatidiform mole, ultrasound
MeSH terms: Case Reports

Background:
Post-molar gestational trophoblastic neoplasia (pGTN) develops in about 15% to 20% of complete hydatidiform mole (CMH). Commonly, pGTN is diagnosed based on hCG monitoring following the molar evacuation. To date, no detailed information is available on how fast can pGTN develop from CHM. However, the concurrence of CHM and pGTN is extremely rare.
Case presentation:
A 29-year-old woman presented to the gynecology department with irregular vaginal bleeding and an elevated hCG serum level. Both ultrasound and MRI showed heterogeneous mass in uterine cavity and myometrium. Suction evacuation was performed and histologic examination of the evacuated specimen confirmed complete hydatidiform mole. Repeated ultrasound showed significant enlargement of the myometrium mass one week after the evacuation. pGTN with prognostic score of 4 was then diagnosed and multi-agent chemotherapy regimen implemented with a good prognosis.
Conclusion:
In rare cases, CMH can rapidly progress into pGTN. Imaging in combination with hCG surveillance seems to play a vital role guiding timely diagnosis and treatment in the specific condition. Low-risk gestational trophoblastic neoplasia (GTN) should be managed stratified according to the individual situation.
Feasibility of exoscopic keyhole surgery: case series
Authors: Miguel Sáez-Alegre, Christian Ríos-Vicil, Keaton Piper, Edinson Najera, Walter C Jean
Journal: Neurosurg Focus Video (2024)
Keywords: exoscope, illumination, keyhole, neurosurgery

Keyhole approaches, performed with the endoscope, microscope, or exoscope, aim to minimize tissue traumatization while maximizing surgical view. The exoscope can provide better ergonomics than the microscope without restricting the space inside of the keyhole, as when using the endoscope. However, a frequently quoted reason for intraoperative exoscope-to-microscope conversion is the absence of sufficient light. In this video, the authors present 4 patients who underwent posterior fossa keyhole surgery without intraoperative conversion. The surgical objective was achieved in all patients without associated morbidity. After adequate adaptation, the exoscope allows sufficient light in the surgical field to perform safe keyhole surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23116.
Non-recurrent right laryngeal nerve identified during endoscopic thyroidectomy via areolar approach: a case report
Authors: Xiaohu Jin, Ronghua Yuan
Journal: Front Surg (2023)
Keywords: case report, endoscopy, nonrecurrent laryngeal nerve, recurrent laryngeal nerve, thyroidectomy
MeSH terms: Case Reports

Background:
Nonrecurrent laryngeal nerve (NRLN) is a rare but significant anatomical variation in thyroid surgery, and lack of awareness of NRLN may lead to intraoperative injury. Here, we report a clinical case of NRLN discovered during endoscopic thyroid surgery via total areola approach in a 23-year-old female patient.
Case presentation:
A 23-year-old female patient presented with bilateral thyroid nodules for three years. She underwent bilateral thyroid nodule fine-needle aspiration biopsy and BRAF gene testing at our hospital, with results indicating bilateral papillary thyroid carcinoma and positive BRAF gene V600E mutation. Neck-enhanced CT revealed bilateral thyroid nodules and the right subclavian artery branching from the aortic arch on the distal side of the left subclavian artery. The patient underwent endoscopic thyroidectomy via total areola approach for radical resection of bilateral thyroid cancer. Intraoperatively, NRLN was found on the right side and RLN on the left side. The surgery was successful, and no postoperative complications were observed. Postoperative pathology confirmed bilateral papillary thyroid carcinoma.
Conclusions:
Although NRLN is a rare occurrence, clinicians should not overlook its presence to prevent serious complications. Preoperative imaging confirmation of the presence or absence of an abnormal subclavian artery course is crucial in preventing the sudden discovery of NRLN during surgery. Endoscopic thyroid surgery via total areola approach is a safe and effective technique but requires a high level of professional skills and an understanding of anatomical variations to prevent nerve injury.
The Role of Electroconvulsive Therapy in the Treatment of Catatonia Associated With Lewy Body Dementia: A Case Report
Authors: Javeria Sahib Din, Thomas Boes, Ernesto Navarro Garcia, Hiba Al-Rubaye
Journal: Cureus (2024)
Keywords: benzodiazepines, bush francis catatonia rating scale, catatonia, dementia with lewy bodies, electro-convulsive therapy
MeSH terms: Case Reports

Catatonia is a complex amalgamation of neuropsychiatric symptoms that can manifest in both psychiatric and neurological conditions. The treatment of catatonia related to psychiatric illnesses is well documented as it typically responds to benzodiazepines and electroconvulsive therapy (ECT). However, the treatment of catatonia related to neurological disorders has shown to be more difficult, particularly when associated with Lewy Body Dementia (LBD). Here, we present the case of a 78-year-old woman with LBD, Bipolar I, depressive type, who successfully underwent twelve ECT sessions to treat catatonia refractory to benzodiazepine therapy. The effectiveness of the treatment was measured using the Bush-Françis Catatonia Scale (BFCS) to measure her catatonic symptoms as she progressed through the therapy. This report highlights the importance of considering ECT as a leading therapeutic approach in this particular subset of patients who do not respond adequately to pharmaceutical therapy and medical titrations.
Unilateral diaphragmatic paralysis and complete brachial plexus injury in a complex birth injury: A rare case report mimicking Tarlov cyst and review of literature
Authors: Khadijeh Sadat Najib, Seyyed Mostajab Razavinejad, Fatemeh Yarmahmoodi, Hamide Barzegar
Journal: Clin Case Rep (2024)
Keywords: tarlov cyst, birth injury, newborn, perineural cyst
MeSH terms: Case Reports

The rare occurrence of Tarlov cysts in pediatric patients, particularly in the context of complex birth injuries, necessitates thorough evaluation and tailored management approaches. A comprehensive understanding of the clinical significance and optimal treatment strategies for this unique combination is crucial to ensure effective and individualized care for affected children.
A Case of Successful Allogeneic Hematopoietic Stem Cell Transplantation in a Severely Underweight Patient with Aplastic Anemia
Authors: Lilija Banceviča, Andrius Žučenka
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Allogeneic hematopoietic stem cell transplantation (alloHSTC) is considered definitive and the most effective treatment for young patients diagnosed with severe aplastic anemia. Low body mass index (BMI) is known to be associated with poorer outcomes in stem cell transplantation and higher mortality risks. Malnutrition negatively affects the patient's ability to mobilize stem cells, therefore reducing patients' stem cell production, although the patient's nutritional status improvement with enteral and parenteral nutrition may reduce the risks of stem cell graft failure and graft-vs-host disease (GVHD) occurrence. The present report demonstrates a severely underweight patient with aplastic anemia and a BMI of 11 kg/m2 who was unsuccessfully treated with immunosuppressive therapy followed by alloHSTC.
Depression with comorbid borderline personality disorder - could ketamine be a treatment catalyst?
Authors: Magdalena Więdłocha, Piotr Marcinowicz, Jan Komarnicki, Małgorzata Tobiaszewska, Weronika Dębowska, Marta Dębowska, Agata Szulc
Journal: Front Psychiatry (2024)
Keywords: borderline personality disorder, depression, esketamine, ketamine, ketamine-assisted psychotherapy (kat), treatment resistant depression (trd)
MeSH terms: Review

Borderline personality disorder (BPD) is diagnosed in 10-30% of patients with major depressive disorder (MDD), and the frequency of MDD among individuals with BPD reaches over 80%. The comorbidity of MDD and BPD is associated with more severe depressive symptoms and functional impairment, higher risk of treatment resistance and increased suicidality. The effectiveness of ketamine usage in treatment resistant depression (TRD) has been demonstrated in numerous studies. In most of these studies, individuals with BPD were not excluded, thus given the high co-occurrence of these disorders, it is possible that the beneficial effects of ketamine also extend to the subpopulation with comorbid TRD and BPD. However, no protocols were developed that would account for comorbidity. Moreover, psychotherapeutic interventions, which may be crucial for achieving a lasting therapeutic effect in TRD and BPD comorbidity, were not included. In the article, we discuss the results of a small number of existing studies and case reports on the use of ketamine in depressive disorders with comorbid BPD. We elucidate how, at the molecular and brain network levels, ketamine can impact the neurobiology and symptoms of BPD. Furthermore, we explore whether ketamine-induced neuroplasticity, augmented by psychotherapy, could be of use in alleviating core BPD-related symptoms such as emotional dysregulation, self-identity disturbances and self-harming behaviors. We also discuss the potential of ketamine-assisted psychotherapy (KAP) in BPD treatment. As there is no standard approach to the application of ketamine or KAP in individuals with comorbid TRD and BPD, we consider further research in the field as imperative. The priorities should include development of dedicated protocols, distinguishing subpopulations that may benefit most from such treatment and investigating factors that may influence its effectiveness and safety.
Case report: Early molecular confirmation and sodium polystyrene sulfonate management of systemic pseudohypoaldosteronism type I
Authors: Einas H Alkhatib, Deirdre Bartlett, Roopa Kanakatti Shankar, Debra Regier, Nadia Merchant
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: decantation, genetics, kayexalate, pediatric endocrinology, pseudohypoaldoaldosteronism, sodium polystyrene sulfonate
MeSH terms: Hyperkalemia, Pseudohypoaldosteronism / diagnosis, Pseudohypoaldosteronism / genetics, Pseudohypoaldosteronism / therapy, Case Reports, Child, Preschool, Electrolytes, Female, Humans, Infant, Infant, Newborn, Polystyrenes / therapeutic use, Sodium, polystyrene sulfonic acid, Polystyrenes, Sodium, Electrolytes

Introduction:
Type 1 pseudohypoaldosteronism (PHA) consists of resistance to aldosterone. Neonatal presentation is characterized by salt wasting, hyperkalemia, and metabolic acidosis with high risk of mortality. Type 1 PHA can be autosomal dominant (renal type 1) or autosomal recessive (systemic type 1). Renal PHA type 1 can be feasibly managed with salt supplementation; however, systemic PHA type 1 tends to have more severe electrolyte imbalance and can be more refractory to treatment.
Case presentation:
We present a case of a 3-year-old girl with systemic PHA type 1, diagnosed and confirmed molecularly in infancy, who has been successfully managed with sodium polystyrene sulfonate decanted into feeds along with sodium supplementation. On day 5 of life, a full-term female infant presented to the ED for 2 days of non-bloody, non-bilious emesis, along with hypothermia to 94°F. Laboratory results were notable for hyponatremia (Na) of 127, hyperkalemia (K) of 7.9, and acidosis with bicarbonate level of 11.2. Genetic testing ordered within a week of life confirmed PHA type 1 with a homozygous pathogenic frameshift variant in SCNN1A c.575delA (p.Arg192GlyfsX57). Sodium polystyrene sulfonate and feeds were decanted until the age of 16 months, and she was also continued on NaCl supplementation. She was gradually transitioned to directly administered sodium polystyrene sulfonate without any electrolyte issues. She has overall done well after gastrostomy-tube (G-tube) placement without severe hyperkalemia even with several hospitalizations for gastrointestinal or respiratory illnesses.
Discussion/conclusion:
A treatment approach to systemic PHA and sodium polystyrene sulfonate administration in neonates and infants is described.
Catastrophic thrombotic events with partial bilateral amputation of legs and fingers in a 12-year-old girl with COVID-19 in Brazil: case report
Authors: Giselly Rosa Modesto Pereira, André Ricardo Araújo da Silva, Claudia Escórcio Gurgel do Amaral Pitanga, Jocemir Ronaldo Lugon
Journal: J Vasc Bras (2024)
Keywords: covid-19, sars-cov-2, amputation, case report, children, thrombosis
MeSH terms: Case Reports

The first case of COVID-19 was detected in Dec 2019, in China. The disease shortly evolved into a pandemic and imposed an unparalleled health and social burden on mankind. Severe forms of COVID-19 mainly affect adults, especially the elderly and those with comorbidities. We report a severe case of COVID-19 in a previously healthy 12-year-old female who was admitted to the emergency room on May 26, 2020, with fever, abdominal pain, vomiting, and diarrhea. During the hospital stay, she tested positive for SARS-CoV-2 and developed multiple organ failure and catastrophic thrombotic events resulting in bilateral amputation of legs and fingers. She was discharged from the hospital for outpatient follow-up after 107 days. By the time this report was written, the patient was undergoing prosthesis prescription and training and regaining her independence to walk.
Asymptomatic fetal bone retention detected 12 years after termination of pregnancy: case report
Authors: İbrahim Kale, Cumhur Selçuk Topal
Journal: Pan Afr Med J (2023)
Keywords: abortion, case report, curettage, intrauterine device, pregnancy termination
MeSH terms: Abortion, Induced / adverse effects, Infertility, Female / etiology, Case Reports, Bone and Bones, Female, Fetus, Humans, Pregnancy, Ultrasonography

Intrauterine retention of fetal bone fragments is a rare complication that can be seen after pregnancy termination, especially in advanced gestational weeks. Here, we present a case of intrauterine fetal bone retention detected during routine gynecological examination in an asymptomatic woman whose pregnancy was terminated 12 years ago. Under local anesthesia and ultrasound guidance, the fetal bone was removed with a grasper. This case report highlights the importance of post-curettage ultrasound examination to ensure that no fetal tissue is left behind after termination of pregnancy.
Vasopressin-Induced Gangrene of the Bilateral Foot Digits and Right Index Finger Managed With Platelet-Rich Plasma Treatment
Authors: Aditya Pundkar, Sandeep Shrivastav, Rohan Chandanwale, Ankit M Jaiswal, Saksham Goyal
Journal: Cureus (2024)
Keywords: angiogenesis, bilateral foot digit, infiltration, prp, regeneration
MeSH terms: Case Reports

Bilateral foot digit gangrene generated by vasopressin is a serious complication for which management and treatment choices are extremely difficult. This case report presents a case of vasopressin-induced gangrene that was successfully treated with platelet-rich plasma (PRP) infiltration. A 20-year-old female patient came with a history of vasopressin treatment, causing bilateral foot digit gangrene and increasing necrosis. The patient's health quickly declined, and conventional care techniques had no effect on enhancing tissue perfusion or stopping the gangrene from getting worse. In our study, we have chosen to use PRP infiltration as an experimental therapeutic technique in light of the restricted choices available. This case study demonstrates the possibility of PRP infiltration as a cutting-edge and effective treatment for vasopressin-induced bilateral foot digit gangrene. The potential of PRP to stimulate angiogenesis, tissue regeneration, and wound healing is essential for optimizing the patient's results. For vasopressin-induced gangrene, more studies are required to evaluate the efficacy of PRP infiltration as a common therapy approach. This case study highlights the important role that PRP infiltration plays in enhancing tissue perfusion, stopping the advancement of necrosis, and promoting recovery.
Giant anterior communicating artery aneurysm with intrasellar extension
Authors: Arunkumar Sekar, Kavin Bharati, Vipin Chandran, Ashis Patnaik
Journal: Brain Spine (2023)
Keywords: acom aneurysm, anterior communicating artery aneurysm, giant intracranial aneurysm, panhypopituitarism
MeSH terms: Case Reports

Introduction:
Aneurysms extending into the sella are uncommon with only a few cases reported till date. Most of these arise from either the supraclinoidal or infraclinoidal segments of the internal carotid artery.
Research question:
Can Anterior communication artery aneurysm present with hypopituitarism due to compression of pituitary gland?
Materials & methods:
Case report and literature review.
Results:
We discuss this rare presentation in a middle-aged patient its surgical management and the follow-up course with a review of available literature.
Discussion & conclusion:
Anterior communicating artery aneurysms extending into the sella are extremely uncommon with only 4 cases reported in literature. They are usually giant aneurysms which are partially thrombosed with presenting with predominantly with mass effect in this case visual impairment and hypofunction of the pituitary.
Case Report: Neurally adjusted ventilatory assist as an effective rescue treatment for pulmonary interstitial emphysema in extremely low birth weight infants
Authors: Chien-Ming Chen, Mei-Yung Chung, Hong-Ya Kang, Mei-Chen Ou-Yang, Teh-Ming Wang, Chung-Ting Hsu
Journal: Front Pediatr (2024)
Keywords: case report, extremely low birth weight infants, neurally adjusted ventilatory assist, non-invasive neurally adjusted ventilatory assist, pulmonary interstitial emphysema
MeSH terms: Case Reports

Pulmonary interstitial emphysema (PIE) is a complication observed in extremely low birth weight (ELBW) infants on mechanical ventilation. Despite various proposed therapeutic interventions, the success rates have shown inconsistency. Neurally adjusted ventilatory assist (NAVA) stands out as a novel respiratory support mode, offering lower pressure and tidal volume in comparison to conventional ventilation methods. In this case report, we present five ELBW infants with refractory PIE who were transitioned to NAVA ventilation. Following the switch to NAVA, all cases of PIE gradually resolved. In contrast to traditional modes, NAVA provided respiratory support with significantly lower fraction of inspired oxygen, reduced peak inspiratory pressure, diminished mean airway pressure, and decreased tidal volume within 7 days of NAVA utilization (p = 0.042, 0.043, 0.043, and 0.042, respectively). Consequently, we propose that NAVA could serve as a valuable rescue treatment for ELBW infants with PIE.