OpenMed/multicare-articles huggingface dataset:
Advanced Atrio-Ventricular Blocks in a Foal Undergoing Surgical Bladder Repair: First Step to Cardiac Arrest?
Authors: Vincent Marolf, Alessandro Mirra, Nathalie Fouché, Cristobal Navas de Solis
Journal: Front Vet Sci (2018)
Keywords: arrhythmia, atropine, bradycardia, hypotension, uroperitoneum

A 3-day-old Swiss Warmblood colt was diagnosed with uroabdomen after urinary bladder rupture. The foal had classical electrolyte abnormalities (hyponatremia, hypochloremia and hyperkalemia) on presentation. The foal was supported prior to surgery with intravenous fluids and the electrolyte abnormalities were treated with physiologic saline, glucose and insulin. Urine could not be drained from the abdomen prior to surgery because the omentum was continuously occluding the drainage cannula and due to progressive abdominal distension, it was decided to pursue surgery without further correction of electrolyte abnormalities. After induction of anaesthesia, signs of hypoxemia were present. Controlled mandatory ventilation using a pressure-controlled ventilation mode with positive end-expiratory pressure was initiated. Urine was drained from the abdomen by free flow. Atrio-ventricular (AV) blocks unresponsive to intravenous antimuscarinic drugs developed. After low dose of epinephrine and cardiac massage, sinus rhythm was restored. Surgery was completed successfully and the foal recovered from anaesthesia. The postoperative period was uneventful and the foal was discharged from the hospital three days later. Based on a clinical case, the purpose of the manuscript is to provide the clinician with potential causes, prevention and treatment of this already known but rarely observed dysrhythmia which could lead to fatal consequences. Definitions of cardiac arrest and asystole are reappraised. We discuss the fact that advanced AV-blocks should be treated as a cardiovascular emergency with advanced life support. The early recognition of advanced AV blocks is the first step to reduce perioperative mortality and morbidity of foal suffering from uroabdomen.
Tube Length Adjustment and Tube Trimming Technique in Refractory Glaucoma
Authors: Iwan Soebijantoro, Nina Asrini Noor
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Secondary glaucoma may develop after vitreoretinal surgery as it is a known risk factor for its development. When the risk factors are more than one, for instance along with neovascular glaucoma (NVG), the secondary glaucoma may become recalcitrant and very difficult to manage. Surgical intervention is often warranted to control intraocular pressure (IOP) and prevent progressive glaucomatous damage in patients with refractory glaucoma, and glaucoma drainage implant may be preferred as the primary choice. We describe a patient who develop secondary glaucoma after vitrectomy and silicone oil (SO) injection due to unresolved vitreous hemorrhage in proliferative diabetic retinopathy (PDR) and subsequent NVG. Baerveldt glaucoma implant (BGI) was carried out and placed in the superotemporal quadrant with longer anterior chamber tube placement to prevent escape of SO through the tube. Qualified success was achieved with additional one fixed-drug combination (FDC). However, 3 years later, the tube was blocked by the iris tissue at the inferior edge of the pupil. Tube trimming was performed efficiently using a simple technique. The distal end of the tube was pulled out of the anterior chamber through a paracentesis just next to the tube entrance and trimmed to the appropriate length. More than a year after the surgery, IOP was still well controlled with the same FDC. Unfortunately, the visual acuity could not be recovered due to advanced PDR.
Hypoacusia in a patient treated by isotretinoin
Authors: L Rosende, M M Verea-Hernando, A de Andrés, F Piñeyro-Molina, J Barja, S Castro-Castro, E Fonseca
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Isotretinoin is the most effective treatment for severe acne, but there are several adverse effects associated with its use, some of them very exceptional (<1/10000). We report one case of hypoacusia and tinnitus in a 15-year-old boy treated with isotretinoin during 6 weeks, who quickly improved after isotretinoin withdrawal. Also, we comment other publications about hearing alterations in patients treated with isotretinoin and other retinoids.
Laparoscopic Resection of Appendiceal Schwannoma
Authors: Toru Imagami, Satoru Takayama, Yohei Maeda, Ryohei Matsui, Masaki Sakamoto, Hisanori Kani
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
Schwannoma arises from Schwann's cell of the neural sheath. Schwannoma of the large intestine, particularly of the appendix, is rare. We report a case of appendiceal schwannoma resected using laparoscopic surgery.
Case presentation:
A 75-year-old man was referred to our hospital for abdominal fullness and nausea since 2 months. Abdominal CT revealed a well-demarcated oval mass of 25 mm at the tip of the appendix. Contrast-enhanced CT revealed a lesion with gradually enhanced contrast from the arterial phase to the equilibrium phase. Abdominal US revealed a well-demarcated hypoechoic tumor. Preoperative diagnosis indicated appendiceal mesenchymal or neuroendocrine tumor. Ileocecal resection with D3 lymph node dissection was performed. Pathological and immunohistochemical findings confirmed the diagnosis of appendiceal schwannoma.
Conclusions:
For determining the surgical procedure of nonepithelial tumor of the appendix, preoperative diagnosis of mesenchymal or neuroendocrine tumors is required. However, appendiceal schwannoma is extremely rare, and its characteristic findings have not yet been established. Accumulating cases of appendiceal schwannomas is necessary for improving imaging diagnosis and surgical treatment.
WU Polyomavirus Infection in Children With Acute Lower Respiratory Tract Infections in China, 2017 to 2019: Case Reports and Multicentre Epidemiological Survey
Authors: Hongwei Zhao, Wenmiao Xu, Lijuan Wang, Yun Zhu, Xiaohui Wang, Yingchao Liu, Junhong Ai, Qianyu Feng, Li Deng, Yun Sun, Changchong Li, Rong Jin, Yunxiao Shang, Hengmiao Gao, Suyun Qian, Lili Xu, Zhengde Xie
Journal: Front Cell Infect Microbiol (2022)
Keywords: wu polyomavirus, acute lower respiratory tract infection, epidemiological survey, fatal case, multicentre study
MeSH terms: Polyomavirus Infections / epidemiology, Polyomavirus / genetics, Respiratory Tract Infections / epidemiology, Case Reports, Multicenter Study, Research Support, Non-U.S. Gov't, Aged, Child, China / epidemiology, Humans, Phylogeny

WU polyomavirus (WUPyV) is a novel member of the family Polyomaviridae recently detected in respiratory tract specimens. So far, it has not been proven whether WUPyV is a real causative agent for respiratory diseases. In this study, we described two patients with fatal infection who had WUPyV detected in their nasopharyngeal swabs. Furthermore, we conducted a multicentre study in six hospitals from different districts of China. WUPyV was detected by real-time polymerase chain reaction assays, and the clinical and molecular epidemiological characteristics of WUPyV strains among hospitalized children with acute lower respiratory tract infections all around China from 2017 to 2019 were analysed. Two complete WUPyV genome sequences were assembled from fatal patients' airway specimens. Phylogenetic tree analysis revealed that they were most closely related to strains derived from Fujian and Chongqing, China, in 2008 and 2013, respectively. In 2017-2019, a total of 1,812 samples from children with acute lower respiratory tract infections were detected for WUPyV, of which 11 (0.6%) were positive. Children aged ≤5 were more susceptible to WUPyV infection. A total of 81.8% of WUPyV-positive patients were coinfected with other viruses, of which rhinovirus enjoyed the highest frequency. The main clinical symptoms of infected patients include fever, coughing and sputum expectoration. Most patients were diagnosed with pneumonia, followed by bronchial surgery. Three patients manifested severe infection, and all patients improved and were discharged. Our results show that WUPyV persistently circulates in China. Further investigations on the clinical role and pathogenicity of WUPyV are necessary.
Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
Authors: Luyue Chen, E Chen, Yanlin Huang, Xinhua Tian
Journal: Open Med (Wars) (2021)
Keywords: brain metastases, intratumoral hemorrhage, rivaroxaban, venous thromboembolism
MeSH terms: Case Reports

Brain metastases (BMs) are the most common intracranial malignancy with poor prognosis. Patients with intracranial tumors are at greater risk for thrombotic complications and intracranial hemorrhage. Rivaroxaban is a potent oral anticoagulant with the high selectivity of direct factor Xa inhibition. The incidence and severity of rivaroxaban-triggered intratumoral hemorrhage (ITH) in patients with BMs remain unknown. A 57-year-old woman was diagnosed with multiple lung, bone, and BMs from unknown primary cancer origin, and refused any invasive procedures to confirm tumor pathology. However, this patient had a relatively favorable outcome after treating with cabozantinib, an inhibitor of multiple tyrosine kinases. The patient survived over 2 years and developed deep vein thrombosis of right lower limb. Oral rivaroxaban was prescribed, and the multifocal catastrophic ITH was encountered after 1 week. The last head computed tomography imaging revealed a rare but typical image of diffuse hemorrhagic metastases. Hemorrhagic-prone BMs, therapeutic rivaroxaban, and cabozantinib treatment increase risks to develop ITH. In this case rivaroxaban was the trigger to this terminal event. This case is a miserable lesson and keeps reminding us to stay vigilant in clinical practice even when there is a potential benefit for anticoagulation in such population.
Can bupropion unmask psychosis
Authors: Sandeep Grover, Partha Pratim Das
Journal: Indian J Psychiatry (2009)
Keywords: bupropion, bipolar depression, psychosis

Bupropion is an antidepressant, which has recently been promoted for the treatment of bipolar depression, because of its lower potency to induced switch. However, due to its dopamine enhancing effect, it has been reported to induce psychosis and perceptual changes. Most of the literature, which is available in relation to development of psychosis while receiving bupropion, has been with the use of immediate release formulation. Some of the case report which have reported development of psychosis with sustained release Bupropion, it has been reported in the background history of over dosage or substance abuse. We present case in which use of bupropion led to development of frank psychosis, which responded to use of antipsychotic medication. However, when antipsychotics were stopped, psychosis again recurred and as a result diagnosis of patient was changed.
18F-FDG PET/CT in a Patient With Malignant Pheochromocytoma Recurrence and Bone Metastasis After Operation-Case Report and Review of the Literature
Authors: Bei Feng, Maojia Chen, Yanghongyan Jiang, Yongfeng Hui, Qian Zhao
Journal: Front Med (Lausanne) (2021)
Keywords: 18f-fdg, bone metastasis, brown fat, malignant pheochromocytoma, recurrence
MeSH terms: Case Reports

Introduction: Bone metastasis of malignant pheochromocytoma is a rare disease. We report a patient with a 10-year history who underwent 18F-FDG PET/CT to detect bone metastasis and receive radiotherapy and chemotherapy with complete response for bilateral iliac pain. Case presentation: A 48-year-old male patient complained of dizziness, hypertension, and bilateral iliac pain for 2 months. The patient had a history of resection of bilateral malignant adrenal pheochromocytoma 10 years earlier, and all complaints were relieved immediately after operation. 18F-FDGPET/CT showed abdominal lymph node uptake and multiple bone uptake, as well as multiple brown fat uptake. A biopsy of the left ilium confirms the metastasis of malignant pheochromocytoma. Discussion: In our literature review, we discuss the metastasis of pheochromocytoma reported by some scholars, and the role of radionuclides such as 18F-FDG PET/CT, 18F-DOPA PET/CT, I-123MIBG, and 68Ga-DOTATATE PET, in the diagnosis of malignant pheochromocytoma. The patient above is a good case for clinicians in the diagnosis and treatment of metastatic pheochromocytoma, especially in some hospitals with only 18F-FDG imaging agents. Conclusion: A review of this case and similar rare cases in the literature illustrates the importance of 18F-FDG PET/CT in the diagnosis of malignant pheochromocytoma.
Double-orifice mitral valve associated with atrioventricular canal defects
Authors: Jaafar Rhissassi, Hicham El Malki, Fatima Azzahra Benmessaoud, Tahar El Kandoussi, Mohamed Laaroussi
Journal: Pan Afr Med J (2016)
Keywords: mitral valve, atrioventricular canal defects, double-orifice
MeSH terms: Dyspnea / etiology, Heart Septal Defects / etiology, Heart Valve Diseases / complications, Mitral Valve / abnormalities, Case Reports, Review, Cardiac Surgical Procedures / methods, Child, Preschool, Heart Septal Defects / diagnosis, Heart Septal Defects / surgery, Heart Valve Diseases / congenital, Heart Valve Diseases / diagnosis, Humans, Male, Atrioventricular Septal Defect

A 4 year-old male presented with effort dyspnea, and was diagnosed as atrioventricular canal defects. This finding was confirmed by open heart surgery, and a congenital double orifice mitral valve was discovered. The septal defect was closed but the double orifice mitral valve was respected because of the absence of hemodynamic disturbance. We report this case with review of literature.
Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain
Authors: Guy Katz, Sharon L Kolasinski, Baskaran Sundaram, Giorgos Loizidis
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Patients with systemic lupus erythematosus (SLE) presenting with chest pain pose a unique diagnostic challenge, with causes ranging from cardiopulmonary disease to esophageal disorders and musculoskeletal chest wall pain. The most common biomarkers for myocardial injury are cardiac troponin T and I (cTnT and cTnI) due to their high sensitivity for the early detection of myocardial infarction. In the idiopathic inflammatory myopathies, cTnT is commonly elevated, and this reflects skeletal muscle breakdown rather than myocardial damage. Similar observations have not been reported in SLE myositis to date. We present two cases of patients with SLE and associated myositis who presented with chest pain and elevated cTnT. Both patients had a normal cTnI, transthoracic echocardiogram, and cardiac magnetic resonance imaging, likely indicating noncardiac chest pain. Clinicians should be aware that the specificity of cTnT might be lower in SLE myositis and that cTnI elevation may be more specific in detecting myocardial insult.
Severe facet joint arthrosis caused c7/t1 myelopathy: a case report
Authors: Toshimi Aizawa, Hiroshi Ozawa, Takeshi Hoshikawa, Takashi Kusakabe, Eiji Itoi
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a "clay-shoveler's" fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.
Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease
Authors: Corinne D'Antico, André Hofer, Jens Fassl, Daniel Tobler, Daniel Zumofen, Luzius A Steiner, Nicolai Goettel
Journal: F1000Res (2016)
Keywords: awake craniotomy, congenital heart disease, conscious sedation

We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease.
Chronic posterior fracture-dislocation of the shoulder: case report and a literature review
Authors: Ahmed Daoudi, Najib Abdeljaouad, Hicham Yacoubi
Journal: Pan Afr Med J (2020)
Keywords: posterior fracture-dislocation, reverse hill-sachs lesion, shoulder
MeSH terms: Fracture Dislocation / surgery, Shoulder Dislocation / surgery, Shoulder Fractures / surgery, Case Reports, Review, Autografts, Female, Follow-Up Studies, Humans, Joint Instability / surgery, Middle Aged, Patient Satisfaction, Scapula / surgery

Posterior shoulder fracture-dislocation is a rare injury accounting for approximately 0.9% of shoulder fracture-dislocations and often misdiagnosed during the initial presentation to a physician. Though the reverse Hill-Sachs lesion is a common injury associated with posterior shoulder dislocation, the associated scapula fracture represents only 6% of the lesions associated with a posterior dislocation of the shoulder. We report the case of a neglected posterior shoulder dislocation with a reverse Hill-Sachs lesion treated by filling with an autologous graft associated with an extra articular fracture of the scapula fixed by a plate and a posterior bone end-stop because of the posterior instability. After two years of follow-up, the patient has no episode of dislocation and is satisfied with the functional result with a constant score of 68/100 points.
Anemia That Presented with Desaturation: A Focus on Core Concepts
Authors: Lakshmi Shobhavat, Antonio D'Costa, Karthik Shroff
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Background. Methemoglobinemia is a potentially life-threatening condition which presents with cyanosis and characteristic "chocolate-coloured blood." Although a co-oximetry would give a prompt diagnosis, there have been multiple reports of misdiagnosing this treatable condition-from being diagnosed as sepsis to asthma and even being operated for "ruptured ectopic pregnancy." Here, we report a case which presented without the classical signs of poisoning and methemoglobinemia-without vomiting, cyanosis, or chocolate-coloured blood. We also discuss the common misconceptions regarding anemia physiology and the pitfalls in diagnosing this condition and warn the reader regarding the reflexive use of antidotes like methylene blue. Case Presentation. A well-grown 3-year old boy presented with an acute history of irritability, cola-coloured urine, and desaturation on examination. The child was pale, with tachypnoea and in failure. Blood smear was suggestive of severe hemolytic anemia. Methemoglobinemia was diagnosed on co-oximetry. By focussing on physiologic principles of management rather than a specific antidote, the child was discharged home, well and active within 3 days of intensive care admission.
Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy
Authors: Jian Hu, Guang Han, Yu Lei, Ximing Xu, Wei Ge, Changli Ruan, Sheng Chang, Aihua Zhang, Xiangpan Li
Journal: Biomed Res Int (2020)
MeSH terms: Mastectomy, Radical, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Intensity-Modulated, Unilateral Breast Neoplasms / diagnostic imaging, Unilateral Breast Neoplasms / therapy, Case Reports, Clinical Trial, Comparative Study, Adult, Aged, Female, Humans, Middle Aged, Radiotherapy Dosage

Results:
The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p < 0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p < 0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques.
Conclusions:
Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.
Thyroid cancer harboring PTEN and TP53 mutations: A peculiar molecular and clinical case report
Authors: Carla Colombo, Gabriele Pogliaghi, Delfina Tosi, Marina Muzza, Gaetano Bulfamante, Luca Persani, Laura Fugazzola, Valentina Cirello
Journal: Front Oncol (2022)
Keywords: pten, sorafenib, tp53, aggressive follicular thyroid cancer, microsatellite instability, mismatch repair proteins, tyrosine kinase inhibitor
MeSH terms: Case Reports

To date, the molecular mechanisms that underline aggressiveness and resistance to tyrosine kinase inhibitors in some thyroid carcinomas (TCs) are not known yet. We report the case of a young patient with a metastatic poorly differentiated (PDTC) and follicular thyroid carcinoma (FTC) refractory to conventional therapies and to Sorafenib. The patient, despite an initial partial response, died of progressive disease 21 months after diagnosis. The genetic analysis performed on the primary tumor and on lymph nodes and distant metastases allowed to identify a frameshift mutation (p.P248Tfs*5) in the PTEN gene, never described in TC. This mutation was present in the primary tumor and, with a lower allelic frequency, in metastases diagnosed after treatment with Sorafenib. Mutations in TP53 (p.C135Y and c.920-2A>G previously detected in anaplastic carcinomas and p.M133R never found in TC) were also detected in the primary tissue together with a mono-allelic expression of the p.C135Y mutant at RNA level. At metastatic sites level, we found only the TP53 splicing mutation c.920-2A>G. The presence of defects in mismatch repair (MMR) proteins and genomic instability was also evaluated. The primary tumor showed a partial expression of MMR proteins together with a strong genomic instability. In conclusion, we demonstrated that the rare combination of somatic PTEN and TP53 mutations in a patient with a metastatic FTC, together with the presence of tumor heterogeneity and genomic instability, might be associated with a high tumor aggressiveness and resistance to treatments.