OpenMed/multicare-articles huggingface dataset:
Case Report: The effect of automated manual lymphatic drainage therapy on lymphatic contractility in 4 distinct cases
Authors: Melissa B Aldrich, John C Rasmussen, Ron J Karni, Caroline E Fife, Frank Aviles, Kristen A Eckert, M Mark Melin
Journal: Front Med Technol (2024)
Keywords: automated mld therapy, complex regional pain syndrome, lymphedema, manual lymphatic drainage, pain, rheumatoid arthritis
MeSH terms: Case Reports

Introduction:
Automated manual lymphatic drainage therapy (AMLDT) is available for home use in the form of a pneumatic mat of 16 pressurized air channels that inflate and deflate to mimic the stretch and release action of manual lymphatic drainage therapy. Four cases (a patient with complex regional pain syndrome and lymphedema, a healthy patient, a breast cancer survivor with chronic pain, and a patient with a history of abdominal surgery) underwent near-infrared fluorescence lymphatic imaging (NIRFLI) with AMLDT to evaluate the effect of AMLDT on lymphatic pumping and pain.
Methods:
Each patient received 32-36 injections of 25 μg indocyanine green (ICG) on the anterior and posterior sides of their body and underwent 1 h of NIRFLI to assess the drainage of ICG laden lymph toward regional nodal basins at baseline. Each patient lay supine on the mat for 1 h of AMLDT with NIRFLI to assess lymphatic flow during treatment. A final NIFRFLI assessment was done 30-60 min posttreatment with the patient in the supine and prone position. Patients reported baseline and posttreatment pain using the Visual Analogue Scale. An imager analyzed NIRFLI images using ImageJ (US National Institutes of Health). Using time stamps of the first and last images to determine time lapsed and the number of pulses observed in a timeframe, pulsing frequency (pulses/min) was obtained to assess lymphatic function.
Results:
All 4 cases completed the NIRFLI and AMLDT without complications; all 3 patients with baseline pain reported reduced pain posttreatment. AMLDT appeared to alter lymphatic contractility, with both increased and decreased pulsing frequencies observed, including in nonaffected limbs. Pulsing frequencies were very heterogeneous among patients and varied within anatomic regions of the same patient.
Discussion:
This proof-of-concept study suggests that AMLDT may impact lymphatic contractility. Further research on its effect on lymphatic function is warranted.
Videofeedback-guided teleintervention for the family of a child with a cochlear implant: a case study
Authors: Ingrid Rafaella Dantas Dos Santos, Wanderson Laerte de Oliveira Carvalho, Joseli Soares Brazorotto
Journal: Codas (2023)
MeSH terms: Cochlear Implantation, Cochlear Implants, Case Reports, Female, Humans, Language, Language Development, Mothers, Parents

Interventions for parental training for families of hard of hearing children, including cochlear implant users, are identified as optimizing their developmental outcomes. In this single-case intervention study, we aim to describe the use of videofeedback in a remote environment, as well as to identify its effectiveness, based on the analysis of mother-child interaction, both for the mother's communicative behaviors and for the behaviors of the mother, receptive and expressive language of the child. Pre- and post-intervention measurements were performed, based on video analysis of the mother's interaction with the child, by blind judges, as well as through the application of assessment instruments for the child and the mother. There were 13 sessions, 3 of which were for evaluation before and after the intervention and 10 of teleconsultation sessions in which the videofeedback tool was used with the mother. Data were analyzed descriptively and inferentially, using the JT method, which determined the Reliable Change Index (BMI) and Clinical Significance. There was reliable positive change in the child's receptive and expressive language, as well as reliable positive change and clinically significant change in mother-child interaction after the 10 sessions of remote videofeedback intervention. Based on the reliable changes observed in this study, we present this model (televideofeedback) as a potential to optimize resources and efforts for therapeutic success in children's auditory rehabilitation, which should be studied in research with a rigorous method, for the broad recommendation of its use.
Delayed Diagnosis of Congenital Duodenal Stenosis in a 16-Year-Old Girl
Authors: Virtut Velmishi, Dritan Alushani, Ermira Dervishi, Saimir Heta, Spiro Sila, Paskal Cullufi
Journal: Case Rep Med (2024)
MeSH terms: Case Reports

Background:
Duodenal atresia or stenosis are different degrees of the same abnormality. They usually occur at the level of the ampulla of Vater and are thought to be an embryologic defect during the development of the foregut, leading to abnormal recanalization. Complete duodenal atresia is usually symptomatic in the early neonatal period, while partial obstruction (web, stenosis) may have a late presentation and a more challenging diagnosis such as in our case. Case Presentation. The patient, a 16-year-old girl, presented with abdominal pain, recurrent vomiting, and growth failure. An upper GI study with barium showed an image compatible with gastroptosis. Further diagnostic procedures confirmed a rare finding such as congenital duodenal stenosis. She underwent surgical intervention, and the recovery period was uneventful.
Conclusion:
Gastroptosis is not diagnostic for a particular disease. This rare radiological finding in children may obscure uncommon diagnosis, such as congenital duodenal stenosis, which can present a diagnostic challenge beyond early childhood.
Anesthetic Management of Cesarean Section in the Case of a Sextuplet Pregnancy and Polycystic Ovarian Syndrome
Authors: Abduljaleel Ethy Ahammedunni, Nadine Borhan Mahmoud Nour, Muhammad Sharif Allah Dad
Journal: Cureus (2024)
Keywords: multiple pregnancy, obstetric anaesthesia, ovarian hyperstimulation, ovulation induction, polycystic ovarian syndrome, sextuplets
MeSH terms: Case Reports

Cesarean section in a mother with a sextuplet pregnancy is challenging for an anesthesiologist. Several perioperative complications are likely because of the overdistended uterus and associated changes in the mother. We are reporting the case of a woman with a sextuplet pregnancy who came for an emergency cesarean. She also had a background history of polycystic ovarian syndrome (PCOS) and ovulation induction for conception. Early pregnancy was complicated by ovarian hyperstimulation syndrome. She required cervical cerclage in early pregnancy. The emergency cesarean was done as she went into preterm labor and six premature babies were delivered at 29 weeks of gestation. Cesarean was done under spinal anesthesia. Preeclampsia and postpartum hemorrhage complicated the perioperative period.
Case Report: Focal cryoablation vs. radiofrequency ablation in a pediatric patient with para-Hisian accessory pathway with effect from the non-coronary aortic cusp
Authors: Zhandos Maksut, Raushan Zhanbolatkyzy, Abay Bakytzhanuly, Almira Bajgalkanova, Yakup Ergül, Omirbek Nuralinov
Journal: Front Pediatr (2024)
Keywords: wolff–parkinson–white syndrome, anteroseptal accessory pathway, case report, non-coronary cusp, para-hisian accessory pathway, pediatric patient, radiofrequency ablation
MeSH terms: Case Reports

A 12-lead electrocardiogram of a pediatric patient with Wolff-Parkinson-White syndrome was consistent with the anteroseptal accessory pathway. The patient had three ablation procedures because of the recurrences of the arrhythmia. In our case, successful cryoablation was performed in the non-coronary cusp of the aortic root.
Case Report: Lymphodepletion followed by CAR-T cell therapy with Idecabtagen vicleucel in a patient with severe renal impairment
Authors: Franziska Marquard, Claudia Langebrake, Dietlinde Janson, Maida Mahmud, Adrin Dadkhah, Nicolaus Kröger, Francis Ayuk
Journal: Front Oncol (2023)
Keywords: car-t-cell therapy, gfr < 30ml/min, cyclophosphamide, dialysis, fludarabine, lymphodepletion
MeSH terms: Case Reports

Acute kidney injury and chronic kidney disease is common in multiple myeloma. Fludarabine which is part of lymphodepletion before CAR-T cell therapy is renally eliminated and its use is not recommended for patients with severe renal impairment defined as a glomerular filtration rate below 30ml/min/1.73m2. We administered fludarabine to a 58-year-old female patient with myeloma-associated severe renal impairment as part of lymphodepletion before Idecabtagen vicleucel infusion. Fludarabine was administered in reduced dose (15mg/m2) and cyclophosphamide with a dose of 300mg/m2 followed by hemodialysis over six hours using a larger filter (FX-100). The therapy was well tolerated with excellent CAR-T cell expansion and complete remission which is ongoing now beyond 12 months.
Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review
Authors: Enfu Tao, Huangjia Zhou, Meili Zheng, Yisha Zhao, Junfen Zhou, Junhui Yuan, Tianming Yuan, Changhua Zheng
Journal: Front Pharmacol (2024)
Keywords: adverse drug reaction, ceftriaxone, cholecystolithiasis, hemolytic anemia, hemolytic crisis, renal calculi
MeSH terms: Case Reports

Ceftriaxone is widely used in pediatric outpatient care for its efficacy against respiratory and digestive system infections, yet its increasing association with severe immune hemolytic reactions requires heightened vigilance from pediatricians. This report details a rare and severe case of ceftriaxone-induced severe immune hemolytic anemia (IHA), hemolytic crisis, myocardial injury, liver injury, renal calculi, and cholecystolithiasis in a previously healthy 3-year-old child. The child, treated for bronchitis, experienced sudden pallor, limb stiffness, and altered consciousness following the fifth day of ceftriaxone infusion, with hemoglobin (Hb) levels precipitously dropping to 21 g/L. Immediate cessation of ceftriaxone and the administration of oxygen therapy, blood transfusion, intravenous immunoglobulin (IVIG), and corticosteroids led to a gradual recovery. Despite initial improvements, the patient's condition necessitated extensive hospital care due to complications including myocardial injury, liver injury, renal calculi, and cholecystolithiasis. After a 12-day hospital stay and a 3-month follow-up, the child showed complete normalization of Hb and liver function and resolution of calculi. In children, ceftriaxone infusion may trigger severe, potentially fatal, hemolytic reactions. Pediatricians must promptly recognize symptoms such as pallor, limb stiffness, and unresponsiveness, indicative of ceftriaxone-induced severe IHA, and immediately discontinue the drug. Effective management includes timely blood transfusion, respiratory support, IVIG administration, and corticosteroids when necessary, along with rigorous vital signs monitoring. Continued vigilance is imperative, even after cessation of ceftriaxone, to promptly address any residual adverse effects.
Brucella infection combined with Nocardia infection: A case report and literature review
Authors: Yan Feng, Chun-Lei Zuo, Jia-Xin Shi
Journal: Open Life Sci (2024)
Keywords: atypical pathogen, brucellosis, co-infection, nocardiosis, pulmonary infection
MeSH terms: Case Reports

Human brucellosis is an infectious disease caused by Brucella and is often misdiagnosed for atypical manifestations including fever of unknown origin, headache, weakness, among else. Nocardiosis is a zoonotic disease caused by the genus Nocardia, which usually spreads through the respiratory tract, skin, and digestive tract. Limited research has documented cases of co-infection involving both Brucella and Nocardia pathogens in patients. A 55-year-old male was admitted to our hospital with intermittent high-grade fever. Following sputum and blood cultures, as well as other laboratory examinations, the patient was diagnosed with concurrent brucellosis and nocardiosis. According to recommendations of previous studies and reports, the patient was successively treated with levofloxacin, doxycycline, piperacillin sodium and sulbactam sodium, trimethoprim-sulfamethoxazole, rifampicin, and tigecycline, after which the patient recovered and was discharged. Brucella and Nocardia are both opportunistic pathogens and simultaneous infection of Brucella and Nocardia is relatively rare. If patients continue to experience persistent fever despite receiving empirical antibiotic therapy, it becomes necessary to conduct examinations to identify potential atypical pathogens, including Brucella and Nocardia. Sputum staining, sputum culture, and blood culture are critical auxiliary examinations during clinical practice. The treatment plan should be selected based on guidelines and the individual patient's condition. Regular reevaluation should be conducted, and antimicrobial agents should be adjusted accordingly.
Nutritional management of a dog with hepatic enzymopathy suspected to be secondary to copper-associated hepatitis: a case report
Authors: Francisco Manuel Poblanno Silva, Caitlin Elizabeth Grant, Érico de Mello Ribeiro, Adronie Verbrugghe
Journal: Front Vet Sci (2023)
Keywords: alanine transaminase, canine, clinical nutrition, dietary copper, hepatoprotective nutrients, homemade diet, liver biopsy, liver disease
MeSH terms: Case Reports

A 4-year-old, female-spayed American Bulldog presented to the Ontario Veterinary College's Health Sciences Center's Clinical Nutrition Service for nutritional management of hepatic enzymopathy and suspected copper-associated hepatitis. Medical history revealed a 3-month history of gradually increasing serum ALT. Additional diagnostics included negative Leptospira titters, normal bile acids, and laparoscopic liver biopsy. Histopathology findings were consistent with diffuse moderate vacuole hepatocellular degeneration, mild positive copper staining, mild chronic lymphoplasmacytic hepatitis both portal and central, and mild biliary hyperplasia. Hepatic copper quantification results were above normal ranges (630 μg/g dry tissue), but below those seen in familial copper-associated hepatitis (>800-1,000 μg/g dry tissue). The patient was prescribed ursodeoxycholic acid, recommended to be fed a homemade diet (HMD), and referred for a nutrition consult. Two days before the nutrition consult, serum ALT fell within the normal range. The body condition score was 5/9, with a good muscle condition score and the dog's appetite and body weight remained stable. Energy intake was appropriate for maintenance. Key nutrient levels of all diets reported were compared to industry standards (AAFCO, NRC, and FEDIAF). Diet history included a commercially available raw meat-based diet (RMBD), of unknown copper content; a high energy commercial dry food (HEC), with copper content higher than the maximum recommended by FEDIAF and immediately prior to nutrition consult the patient had been eating an unbalanced homemade diet (HMD1) for 4 weeks. HMD1 was low in copper and deficient in the hepatoprotectant nutrients vitamin E and zinc. As per the owner's preference and to accommodate the patient's unique nutritional needs, a homemade diet addressing key nutrients for liver disease was formulated (HMD2), with copper content just above the recommended minimum. The new diet was found palatable and the patient's body weight, body, and muscle condition scores remained unchanged. Two months after starting HMD2, all bloodwork values remained within the normal range, including ALT. The reduction of dietary copper content likely reduced serum ALT. However, unbalanced diets cause a risk of nutrient deficiencies and excess. This dog was maintained with no known adverse effects on a complete and balanced HMD diet with a moderately low copper content, moderate protein, and inclusion of hepatoprotective nutrients.
Persistent hiccups due to aripiprazole: a case report and review of the literature
Authors: Yaoyin Zhang, Wei Chen, Junming Chen, Mingmei Li, Yulan Huang, Wenjiao Min
Journal: Front Pharmacol (2024)
Keywords: adverse effects, aripiprazole, hiccup, management, psychosocial factor
MeSH terms: Case Reports

Introduction: Aripiprazole, a commonly prescribed antipsychotic, has been rarely associated with the onset of hiccups. This study aims to elucidate the prevalence, risk factors, and management of aripiprazole-induced hiccups. Methods: We report a case of aripiprazole-induced hiccups in a 32-year-old male diagnosed with Somatic Symptom Disorder per DSM-5 criteria.A comprehensive literature review was conducted, identifying 29 case reports of aripiprazole-induced hiccups. Patient demographics, dosage, onset and duration of hiccups, and management strategies were analyzed. Results: Aripiprazole-induced hiccups predominantly affected adolescents and middle-aged male patients (86.7%). The majority of hiccups developed within 1-2 days post-prescription (90.9%) and resolved within 1-4 days after discontinuation of aripiprazole. Discontinuation of aripiprazole was the most effective management strategy (51.7%). Co-administration with benzodiazepines was identified as a significant risk factor. Discussion: The findings suggest that clinicians should be vigilant for the onset of hiccups during the early stages of aripiprazole treatment, especially in male patients and those co-administered with benzodiazepines. Conclusion: Clinicians should be vigilant for hiccups during early aripiprazole treatment. Considering personality and psychological factors is crucial in managing hiccups in psychiatric patients.
Familial hemiplegic migraine type 2: a case report of an adolescent with ATP1A2 mutation
Authors: Hui Zhang, Li Jiang, Yuqi Xian, Sen Yang
Journal: Front Neurol (2024)
Keywords: atp1a2, adolescent, case report, familial hemiplegic migraine, hemiplegia
MeSH terms: Case Reports

This study presents a case report of a male adolescent diagnosed with familial hemiplegic migraine type 2 (FHM2), an autosomal dominant inheritance disorder caused by ATP1A2 mutation. We report the patient who presented with headache, aphasia, and left-sided weakness. Cerebrovascular disease and various infectious agents were unremarkable during the patient's extended hospital stay. Our case revealed that brain hyperperfusion in familial hemiplegic migraine (FHM) persists over an extended duration, and despite the disease being in a state of recovery, enhanced brain magnetic resonance imaging (MRI) continues to exhibit hyperperfusion. A genetic testing was performed which revealed a mutation in the FHM2 gene (c.1133C > T). The patient has been followed for 3 years after hospital discharge. The boy suffered four episodes of hemiplegia and multiple episodes of headaches, and gradually developed seizures and cognitive impairment. It is advisable to consider FHM as a potential diagnosis for patients presenting with typical symptoms such as recurrent paroxysmal headaches and limb activity disorders.
Pulmonary granulomas confirmed in Blau syndrome using TBLC specimens: Case report
Authors: Yasuo Shimizu, Yoshitomo Kushima, Ayae Tanaka, Akihiro Takemasa, Kazuyuki Ishida, Seiji Niho
Journal: Front Med (Lausanne) (2024)
Keywords: blau syndrome, nod2, bronchoscopy, cryobiopsy, granulomas, interstitial lung disease, lung, sarcoidosis
MeSH terms: Case Reports

Blau syndrome (BS), is an autoinflammatory granulomatosis disease characterized by a distinct triad of skin, joint, and eye disorders similar to those of sarcoidosis, but the lung involvement frequently observed in sarcoidosis are rare. Granulomas from patients with BS displayed a distinct morphology indicating an exuberant chronic inflammatory response. Patients with BS may have granulomatous lung lesions, which require early diagnosis. To determine whether therapeutic intervention is needed for lung lesions, examining transbronchial lung cryobiopsy specimens and accumulating cases of BS with lung involvement could be contributed to improving BS management in the future.
RESECTION OF ANKLE TUMOR LESION AND RECONSTRUCTION WITH THE USE OF ALLOGRAFT
Authors: Diego Perez DA Motta, Beatriz Gomes Arruda, Rafael DE Castro E Silva Pinheiro, Gabriel Araújo Ribeiro, Bruna Canteri Delocco, Bruno DE Oliveira Fiorelli, Eduardo Alessandro Lima Witte, Walter Meohas
Journal: Acta Ortop Bras (2023)
Keywords: bone nails, bone neoplasms, orthopedic procedures, tibia

Reconstruction of the distal third of the tibia due to resection of a malignant tumor has some hindering factors, such as a thin subcutaneous layer, neurovascular bundles that cross compartments, prolonged operative duration, specific orthopedic material, and a trained multidisciplinary team. Allografting with material from tissue banks is part of this orthopaedic arsenal.
Objective:
To describe the protocol used at Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad.
Methods:
Series of six cases subjected to resection with oncologic margins, allograft reconstruction, and use of a retrograde ankle nail as limb-salvage surgery. Three of the six patients were women, the lesions were on average 9.3 cm long, and the average operative duration was 3.25 hours.
Results:
The main short-term complication (≤ 30 days) was peroneal nerve palsy, while the main long-term complication (> 30 days) was surgical site infection (two cases). Consolidation of the two foci occurred in three patients, and two patients developed asymptomatic pseudoarthrosis of the proximal focus with consolidation of the distal focus.
Conclusion:
Despite the complications, the proposed surgery gives patients the chance to preserve their limb in the face of immediate radical surgery. Level of Evidence IV, Case Series.
A rare case of right renal ectopia with ureteral triplication in a 37-year-old male: a case report
Authors: Sejal Sanjeev Joshi, Avinash Parashuram Dhok, Kajal Ramendranath Mitra, Prashant Madhukar Onkar
Journal: Pan Afr Med J (2023)
Keywords: ureteral triplication, wolffian duct, case report, renal ectopia, urography computed tomography
MeSH terms: Choristoma, Kidney Diseases, Ureter / abnormalities, Ureter / diagnostic imaging, Case Reports, Adult, Humans, Kidney / abnormalities, Kidney / diagnostic imaging, Kidney Pelvis, Male, Urography

Ureteral triplication is one of the least encountered congenital malformations of the upper urinary tract. We report a case of a 37-year-old male patient with right renal ectopia with triplication of the ureter which was diagnosed via computed tomography (CT) urography. This is an intriguing example because, as we discovered after reviewing the literature, the presentation is distinctive.