OpenMed/multicare-articles huggingface dataset:
Angiotensin II: A Multimodal Approach to Vasoplegia in a Cardiac Setting
Authors: William Sovic, Christo Mathew, Britton Blough, Kara-Ann Monday, Teena Sam, Hira Zafar, Cesar Guerrero-Miranda, Melody Sherwood, Christopher Hebert, Shelley Hall, Amit Alam
Journal: Methodist Debakey Cardiovasc J (2021)
Keywords: angiotensin ii, heart failure, shock, vasoplegia
MeSH terms: Heart Transplantation / adverse effects, Heart-Assist Devices / adverse effects, Vasoplegia / diagnosis, Vasoplegia / drug therapy, Vasoplegia / etiology, Case Reports, Angiotensin II, Humans, Retrospective Studies, Angiotensin II

Patients experiencing vasoplegia, a type of distributive shock, have limited options when conventional vasopressors are not appropriate or sufficient. This is especially true for patients with cardiac dysfunction, whether after heart transplant or ventricular assist device (VAD) implantation. Angiotensin II has been used in various clinical settings for distributive shock; however, its role in patients after orthotopic heart transplant or VAD implantation is not well studied. We present two cases where angiotensin II played a vital role in correcting vasoplegia for critical cardiac patients.
Visual Puzzles, Figure Weights, and Cancellation: Some Preliminary Hypotheses on the Functional and Neural Substrates of These Three New WAIS-IV Subtests
Authors: Simon M McCrea, Thomas P Robinson
Journal: ISRN Neurol (2011)

In this study, five consecutive patients with focal strokes and/or cortical excisions were examined with the Wechsler Adult Intelligence Scale and Wechsler Memory Scale-Fourth Editions along with a comprehensive battery of other neuropsychological tasks. All five of the lesions were large and typically involved frontal, temporal, and/or parietal lobes and were lateralized to one hemisphere. The clinical case method was used to determine the cognitive neuropsychological correlates of mental rotation (Visual Puzzles), Piagetian balance beam (Figure Weights), and visual search (Cancellation) tasks. The pattern of results on Visual Puzzles and Figure Weights suggested that both subtests involve predominately right frontoparietal networks involved in visual working memory. It appeared that Visual Puzzles could also critically rely on the integrity of the left temporoparietal junction. The left temporoparietal junction could be involved in temporal ordering and integration of local elements into a nonverbal gestalt. In contrast, the Figure Weights task appears to critically involve the right temporoparietal junction involved in numerical magnitude estimation. Cancellation was sensitive to left frontotemporal lesions and not right posterior parietal lesions typical of other visual search tasks. In addition, the Cancellation subtest was sensitive to verbal search strategies and perhaps object-based attention demands, thereby constituting a unique task in comparison with previous visual search tasks.
Mild SARS-CoV-2 Infection After Gene Therapy in a Child With Wiskott-Aldrich Syndrome: A Case Report
Authors: Sabina Cenciarelli, Valeria Calbi, Federica Barzaghi, Maria Ester Bernardo, Chiara Oltolini, Maddalena Migliavacca, Vera Gallo, Francesca Tucci, Federico Fraschetta, Elena Albertazzi, Elena Sophia Fratini, Giulia Consiglieri, Stefania Giannelli, Francesca Dionisio, Claudia Sartirana, Sara Racca, Chiara Camesasca, Giovanni Peretto, Rita Daverio, Antonio Esposito, Francesco De Cobelli, Paolo Silvani, Marco Rabusin, Andrea Cara, Daria Trabattoni, Stefania Dispinseri, Gabriella Scarlatti, Lorenzo Piemonti, Vito Lampasona, Maria Pia Cicalese, Alessandro Aiuti, Francesca Ferrua
Journal: Front Immunol (2020)
Keywords: wiskott-aldrich syndrome, gene therapy, immune reconstitution, primary immunodeficiencies, severe acute respiratory syndrome coronavirus 2 (2019-ncov)
MeSH terms: Antibodies, Neutralizing / blood, Antibodies, Neutralizing / immunology, Antibodies, Viral / blood, Antibodies, Viral / immunology, COVID-19 / blood, COVID-19 / immunology, COVID-19 / therapy, Genetic Therapy, SARS-CoV-2 / immunology, SARS-CoV-2 / metabolism, Wiskott-Aldrich Syndrome / blood, Wiskott-Aldrich Syndrome / immunology, Wiskott-Aldrich Syndrome / therapy, Case Reports, Humans, Infant, Male, Wiskott-Aldrich Syndrome Protein / biosynthesis, Wiskott-Aldrich Syndrome Protein / immunology, Antibodies, Neutralizing, Antibodies, Viral, WAS protein, human, Wiskott-Aldrich Syndrome Protein

In this work we present the case of SARS-CoV-2 infection in a 1.5-year-old boy affected by severe Wiskott-Aldrich Syndrome with previous history of autoinflammatory disease, occurring 5 months after treatment with gene therapy. Before SARS-CoV-2 infection, the patient had obtained engraftment of gene corrected cells, resulting in WASP expression restoration and early immune reconstitution. The patient produced specific immunoglobulins to SARS-CoV-2 at high titer with neutralizing capacity and experienced a mild course of infection, with limited inflammatory complications, despite pre-gene therapy clinical phenotype.
A case of anterior choroidal artery occlusion test under MEP monitoring for a recurrent internal carotid artery-anterior choroidal artery bifurcation aneurysm clipping
Authors: Yosuke Suzuki, Kosumo Noda, Souichirou Yasuda, Yasuaki Okada, Syun Ono, Katsunari Kiko, Kohei Yoshikawa, Norio Miyoshi, Tomomasa Kondo, Kenichi Haraguchi, Jyunpei Oda, Nakao Ota, Hiroyasu Kamiyama, Sadahisa Tokuda, Rokuya Tanikawa
Journal: J Surg Case Rep (2023)
Keywords: anterior choroidal artery, internal carotid artery, intracerebral aneurysm, motor-evoked potential monitoring, occlusion test, surgical clipping
MeSH terms: Case Reports

A 59-year-old female with recurrent Anterior Choroidal Artery (AchA) aneurysm was elected for surgery at our institution through a standard pterional approach. Two thin perforating branches were found to origin from the dome of the aneurysm during operation, and therefore complete aneurysm clipping preserving these branches was not feasible. These perforating branches were temporarily occluded under motor-evoked potential (MEP) monitoring. The MEPs remained stable during 10 min of temporary clipping, and we concluded that these branches could be sacrificed, and therefore neck clipping was performed occluding these tiny AchA perforators. Although postoperative magnetic resonance imaging with diffusion-weighted images showed ischemic signs in left AchA territory after the operation, the patient remained asymptomatic and was discharged home with mRS 0.
Screening and identification of nucleocapsid protein-nanobodies that inhibited Newcastle disease virus replication in DF-1 cells
Authors: Wenqi Fan, Pinpin Ji, Xuwen Sun, Min Kong, Ning Zhou, Qiang Zhang, Ying Wang, Qianqian Liu, Xiaoxuan Li, En-Min Zhou, Qin Zhao, Yani Sun
Journal: Front Microbiol (2022)
Keywords: newcastle disease virus, inhibition, nanobody, nucleocapsid protein, viral replication

Newcastle disease (ND) is an acute and highly contagious infectious disease found in poultry. Although commercial ND virus (NDV) vaccines are universally used, some case reports persistently documented vaccination failure. Therefore, novel strategies are still required to control the occurrence of the disease in chickens. Recently, nanobodies (Nbs), which have the advantages of small molecular weight and low production costs, have been shown to be promising therapeutics against viral infection. In the present study, a total of 16 Nbs against NDV nucleocapsid protein (NP) were screened from two libraries against NDV using phage display technology. Of the 16 screened Nbs, eight were prevented from binding to NDV NP protein through administering positive chicken sera for anti-NDV antibodies, indicating that the epitopes recognized by these eight Nbs were able to induce the immune response after the chickens were infected with NDV stock. Subsequently, transfection assay, construction of recombinant DF-1 cells capable of expressing different nanobodies and viral inhibition assay were used to screen the nanobodies inhibiting NDV replication. The results demonstrated that Nb18, Nb30, and Nb88 significantly inhibited the replication of Class I and different genotypes of Class II NDV strains in DF-1 cells when they were expressed in the cytoplasm. Collectively, these nanobodies provided new tools for researching the functions of NDV NP protein and may be used as a novel strategy for designing drugs against NDV infection in chickens.
Mispositioned Hydrus Microstents: A Case Series Imaged with NIDEK GS-1 Gonioscope
Authors: Daniel Laroche, Alexander Martin, Aaron Brown, Sohail Sakkari, Chester Ng
Journal: J Ophthalmol (2022)

Introduction. The Hydrus microstent has become a common procedure in glaucoma surgery intended to improve outcomes of cataract surgery to lower intraocular pressure. Despite proper placement, this device can subsequently be noted to not be in the proper position. In this case series, we report mispositioned Hydrus microstents in five different patients and use NIDEK GS-1 gonioscopy. Case Report. We report five different patients who had cataract surgery and who were subsequently noted to have mispositioned Hydrus stents. No stents needed to be removed. All patients had improved vision and stable visual fields, and none required secondary surgery. Management and Outcome. In each case of mispositioned stents, vision was significantly improved and there was no inflammation or other complications noted. Discussion. Hydrus stents can be noted to be mispositioned during the post-operative period after successful insertion. This can often be well tolerated requiring no further intervention.
The pathogenicity of novel GUCY2D mutations in Leber congenital amaurosis 1 assessed by HPLC-MS/MS
Authors: Xue Feng, Tianying Wei, Junhui Sun, Yuqin Luo, Yanan Huo, Ping Yu, Jiao Chen, Xiaoming Wei, Ming Qi, Yinghui Ye
Journal: PLoS One (2020)
MeSH terms: Cyclic GMP / analysis, Guanylate Cyclase / genetics, Leber Congenital Amaurosis / genetics, Receptors, Cell Surface / genetics, Case Reports, Research Support, Non-U.S. Gov't, Cell Membrane / metabolism, Child, Preschool, China, Chromatography, High Pressure Liquid, Cyclic GMP / metabolism, DNA Mutational Analysis, Enzyme Assays / methods, Female, Guanylate Cyclase / metabolism, HeLa Cells, Heterozygote, High-Throughput Nucleotide Sequencing, Humans, Leber Congenital Amaurosis / diagnosis, Male, Mutagenesis, Site-Directed, Mutation, Pedigree, Receptors, Cell Surface / metabolism, Recombinant Proteins / genetics, Recombinant Proteins / metabolism, Tandem Mass Spectrometry, Receptors, Cell Surface, Recombinant Proteins, guanylate cyclase 1, Guanylate Cyclase, Cyclic GMP, Amaurosis congenita of Leber, type 1

Leber congenital amaurosis (LCA) is a group of severe congenital retinal diseases. Variants in the guanylate cyclase 2D gene (GUCY2D), which encodes guanylate cyclase 1 (ROS-GC1), are associated with LCA1 and account for 6%-21% of all LCA cases. In this study, one family with LCA1 was recruited from China. A combination of next generation sequencing and Sanger sequencing was used to screen for disease-causing mutations. We found three novel mutations (c.139delC, p.Ala49Profs*36; c.835G>A, p.Asp279Asn and c.2783G>A, p.Gly928Glu) in the GUCY2D gene. Proband III-2 carries mutations c.139delC and c.2783G>A, which are inherited from the heterozygous mutation carriers, II-2 (c.139delC) and II-3 (c.2783G>A) that possess c.139delC and c.2783G>A. Additionally, II-8 carries heterozygous mutation c.835G>A. Sanger sequencing was used to confirm the presence of the three novel mutations in other family members. Mutation c.139delC results in a truncated protein. Mutations c.835G>A and c.2783G>A significantly reduce the catalytic activity of ROS-GC1. Our findings highlight the gene variants range of LCA. Moreover, HPLC-coupled tandem mass spectrometry (HPLC-MS/MS) was used to analyze the concentration of 3',5'-cyclic guanosine monophosphate (cGMP), suggesting that HPLC-MS/MS is an effective alternative method to evaluate the catalytic activity of wild-type and mutant ROS-GC1.
A case series of benign transient hyperphosphatasemia from a pediatric endocrinology reference health facility in Turkey
Authors: Fatma Dursun, Heves Kirmizibekmez
Journal: Pan Afr Med J (2018)
Keywords: benign, alkaline phosphatase, hyperphosphatasaemia, transient
MeSH terms: Alkaline Phosphatase / blood, Bone Diseases / diagnosis, Liver Diseases / diagnosis, Bone Diseases / enzymology, Bone and Bones / enzymology, Child, Preschool, Diagnosis, Differential, Female, Humans, Infant, Liver / enzymology, Liver Diseases / enzymology, Male, Retrospective Studies, Turkey, Alkaline Phosphatase

Introduction:
Benign transient hyperphosphatasemia (BTH), even a known condition, is not very well managed by primary care physicians. The diagnostic criteria for BTH were alkaline phosphatase (ALP) levels above 3-5 times greater than the age adjusted upper limit of normal among children under 5 years with no evidence of liver or bone disease whose ALP values resolved within 4 months.
Methods:
This study involved 15 patients aged 0-5 years, who were referred to the pediatric endocrinology clinic for elevated ALP levels. They were diagnosed with BTH. We examined demographic and biochemical parameters including ALP and ALP isoenzymes, liver enzymes, calcium, phosphate, and parathormone (PTH) levels to rule out liver or bone disease as a cause for hyperphosphatasaemia.
Results:
Of 15 patients 7 were male and 8 were female. Mean age was 2.45 ± 1.09 (range 1.2-4.6) years. Mean serum ALP level was 2315 ± 1028 IU/L (1102-4662), while liver enzymes, calcium, phosphate, PTH and vitamin D3 levels were in normal ranges. The mean normalization period of ALP was 2.4 ± 1.1 (0.5-4) months, and all were normal at the end of 4 months without any treatment.
Conclusion:
This study and literature knowledge related to BTH has shown that being aware of BTH is very important for a primary care physician. Paediatricians can conveniently manage the differential diagnosis and follow up this period of elevated ALP.
Case Report: Immunotherapy for low-grade myofibroblastic sarcoma of the pharynx
Authors: Bao Sun, Zhiying Luo, Ping Liu, Yan He, Shasha He, Wenhui Liu
Journal: Front Immunol (2023)
Keywords: immunotherapy, low-grade myofibroblastic sarcoma, pembrolizumab, pharynx, recurrence and multiple metastases
MeSH terms: Fibrosarcoma / pathology, Pharynx, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Immunotherapy, Male, Myofibroblasts / pathology, Neck / pathology

Low-grade myofibroblastic sarcoma (LGMS) characterized by the increased proliferation of myofibroblasts is a rare type of malignant myofibroblastic tumor that frequently occurs in the head and neck region. Presently, there is no consensus regarding the treatment of LGMS. Here, we report a rare case of LGMS of the pharynx in a 40-year-old male admitted to our hospital. The patient underwent resection for a right metastatic lesion and parapharyngeal mass. However, he had recurrence and multiple metastases without a surgical indication. Then the patient received the treatment of anlotinib plus pembrolizumab for 4 cycles, and there was a partial response (PR) to the treatment. Due to the adverse reaction of anlotinib, the patient subsequently received monotherapy of pembrolizumab for 22 cycles and achieved a complete response (CR). As the first case report of the immunotherapy for LGMS, our study highlights that this strategy may be of great significance to the treatment of LGMS.
Resistant hypertension caused by stenosis of the aorta in elderly women: three case reports
Authors: Hee Dong Kim, Mi-Na Kim, Su-A Kim, Sue In Choi, Jah Yeon Choi, Ji Hye Seo, Sung Hoon Park, Seong-Mi Park, Wan-Joo Shim
Journal: Clin Hypertens (2014)
Keywords: aortic stenosis, resistant hypertension, takayasu arteritis
MeSH terms: Case Reports

Arterial hypertension is the most common cardiovascular disease in older than middle-aged patients. Reported incidence of secondary hypertension in this age group is around 10%. To evaluate secondary hypertension, history taking and physical examination should be precise, which are usually not routinely performed in busy outpatient clinic. Here, we report three cases of elderly women who are taking antihypertensive and visited outpatient clinic for uncontrolled hypertension. Their diagnosis of aortic stenosis was delayed, and its presence was suggested by detection of high abdominal aortic flow velocity during transthoracic echocardiography. This case report gives us lessons that suspicion of secondary hypertension and careful physical examination are most important to make diagnosis early.
Spontaneous pneumothorax as an atypical presentation of pulmonary paracoccidioidomycosis: a case report with emphasis on the imaging findings
Authors: Mariana Leite Pereira, Edson Marchiori, Gláucia Zanetti, Guilherme Abdalla, Nina Ventura, Carolina Pesce Lamas Constantino, Viviane Brandão, Pedro Martins, Rodrigo Canellas, Antonio Muccillo, Romulo Varella de Oliveira
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

We describe the case of a 45-year-old male with pulmonary paracoccidioidomycosis and spontaneous pneumothorax. The patient presented to the hospital with sudden and intense chest pain accompanied by dyspnea and had a six-month history of dry cough, weight loss, and progressive dyspnea on exertion. Chest X-ray showed a small right pneumothorax, bilateral nonhomogeneous opacities, and emphysematous areas in the lung base. Chest computed tomography showed consolidation in both lungs, with architectural distortion, nodules, interlobular septal thickening, and emphysema, in addition to the right pneumothorax. A lung biopsy revealed yeast consistent with Paracoccidioides brasiliensis. No drainage was needed, and the lung was re-expanded. The patient was treated with antifungal drugs, showed mild improvement, and was referred to outpatient care.
Biventricular Impella (Bi-Pella) in Refractory Cardiogenic Shock: The First Case from the Middle East
Authors: Abdulaziz Almejren, Abdullah Alenezi
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Cardiogenic shock (CS) associated with biventricular failure (BiVF) carries significant in-hospital morbidity and mortality. We describe here the successful use of percutaneous biventricular Impella (Bi-Pella) for cardiogenic shock secondary to acute biventricular myocardial infarctions (AMI-CS), as guided by parameters such as mixed venous oxygen saturation (SvO2), pulmonary artery pulsatility index (PAPi), central venous pressure (CVP), and cardiac power output (CPO). We aim to highlight the promising outcomes of timely implanted biventricular Impella in (AMI-CS).
Use of Autologous Platelets for Lamellar Macular Hole Repair
Authors: Andres Gonzalez, Sarina Amin, Omar Iqbal, Stephen Myles Potter, Syed Gibran Khurshid
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

The consensus of lamellar macular hole repair generally entails vitrectomy with internal limiting membrane with/without epiretinal membrane peeling with gas tamponade, although the risk of a full thickness macular hole remains. In this case report, we investigate the role of the regenerative properties of autologous platelets in the repair of a lamellar macular hole with pars plana vitrectomy, an autologous platelet plug, and 12% C3F8 without prone posturing. All three patients in this case report experienced visual improvement along with anatomic closure of the lamellar macular hole. Further randomized studies with larger sample sizes will contribute to the existing data regarding this procedure and its outcomes.
Abdominal apoplexy due to rupture of inferior pancreaticoduodenal artery: A rare case of acute abdomen
Authors: Adel Zeinalpour, Amirhossein Aghili, Barmak Gholizadeh
Journal: Caspian J Intern Med (2021)
Keywords: acute abdomen, hemoperitoneum, mesenteric arteries
MeSH terms: Case Reports

Background:
Abdominal apoplexy is one of the rare causes of non-traumatic intra-abdominal bleeding. This condition is usually seen in male patients in their 50s with history of hypertension. As soon as abdominal apoplexy is suspected, immediate resuscitation should be performed followed by emergent surgery. The patient's outcome depends entirely on the clinical condition and the time interval between diagnosis and treatment.
Case presentation:
Herein we present a 63-year-old man with idiopathic spontaneous intraperitoneal hemorrhage (ISIH) caused by spontaneous rupture of non-aneurysmal inferior pancreaticoduodenalartery (IPDA).
Conclusion:
In this report, a case of abdominal apoplexy has been presented caused by spontaneous rupture of non-aneurysmal inferior pancreaticoduodenalartery (IPDA) in a patient without any significant past medical history.
Delayed Presentation of Congenital Diaphragmatic Hernia with Acute Respiratory Distress: Challenges in Diagnosis and Management
Authors: Kam Lun Hon, Ronald C M Fung, Alexander K C Leung
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Delayed presentation of congenital diaphragmatic hernia (CDH) with acute respiratory distress beyond the newborn period may poise challenges in diagnosis and management. We report a 3-month-old infant who presented with acute-onset respiratory distress and left congenital diaphragmatic hernia that was relieved with thoracoscopic repair. CDH must be differentiated from pneumothorax or pulmonary cyst. Erroneous diagnosis and treatment with thoracocentesis could be disastrous. Pediatricians and surgeons must be aware of this condition to allow early diagnosis and expeditious management. Subcutaneous emphysema should not be misdiagnosed as pneumothorax and management is expectant.
Transcatheter Arterial Chemoembolization and Chemotherapy plus Sorafenib in a Large Hepatocellular Carcinoma with Arterioportal Shunt
Authors: Jun Chen, Shixi Chen, Wei Xi, Bei Wu, Hui Yu, Yang Gao
Journal: Case Rep Oncol Med (2014)

Introduction. Arterioportal shunts (APS) are sometimes encountered in patients with hepatocellular carcinoma (HCC) and associated with poor prognosis. The management of HCC with APS is a challenge so far. Case Presentations. We report here in detail a 37-year-old man who was diagnosed as an advanced HCC accompanied with severe APS and treated by two sessions of transcatheter arterial chemoembolization (TACE) and three sessions of transcatheter arterial chemotherapy (TAC) plus sorafenib therapy. The tumor shrinks were revealed continuously during 152 days after the diagnosis. Although tumor progress emerged at 209 days after the diagnosis, the patient remarkably achieved 366-day survival. Discussion. TACE plus sorafenib may be a promising treatment for advanced HCC accompanied with APS. Prospective case-control studies should be advocated to evaluate the combination of TACE, TAC, and sorafenib in the management of HCC with APS.
Levosimendan as treatment option in severe verapamil intoxication: a case report and review of the literature
Authors: Mirjam Osthoff, Christine Bernsmeier, Stephan C Marsch, Patrick R Hunziker
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Cardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such as ventricular pacing or mechanical circulatory support. Still, mortality remains high. Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management.