OpenMed/multicare-articles huggingface dataset:
Pseudoaneurysm: A complication of laparoscopic inguinal hernia repair
Authors: Brijendra Singh, Vaibhav Gupta, Shahana Gupta
Journal: Int J Surg Case Rep (2019)
Keywords: case report, complications of laparoscopic inguinal hernia repair, laparoscopic inguinal hernia repair, pseudo aneurysm

Introduction:
Laparoscopic inguinal hernia repair has gained importance during last few decades, because of its several advantages. However, it has its own set of complications, which can be avoided by following the basic anatomical principles of laparoscopic inguinal hernia repair.
Presentation of case:
An 85-year-old male patient, developed a painless intraabdominal lump following laparoscopic inguinal hernia repair. Clinical and radiological evaluation was suggestive of pseudo aneurysm. Intra operative findings revealed a pseudo aneurysm arising from the right deep circumflex iliac artery. Excision of the pseudo aneurysm with incorporated mesh along with orchidectomy followed by fascial repair was performed.
Discussion:
Pseudo aneurysm refers to a defect in an arterial wall, which allows communication of arterial blood with the adjacent extra-luminal space. Blood extravasates out of the artery, which is contained by surrounding soft tissue and compressed thrombus that forms a cavity or sac. With the increasing utilization of percutaneous arterial interventions worldwide, iatrogenic arterial injury has become the predominant cause of pseudo aneurysm formation. Here we report a case on pseudo aneurysm arising from deep circumflex iliac artery following laparoscopic inguinal hernia repair. This complication can be avoided by following the basic principles of surgical anatomy of the pelvis and groin as viewed through the laparoscope.
Conclusion:
Pseudo aneurysm complicating laparoscopic inguinal hernia repair is a rare occurrence. Injury to seemingly small artery can lead to evolution of pseudoaneurysm. Adherence to surgical principle will avoid such a complication.
Management of a Hypomineralisation of the Enamel by Applying a Remineraliser Based on Zinc Hydroxyapatite (microRepair)
Authors: G Solinas, V Grabesu, M Lattari, R Strinna, N Arnould, A A Amodeo
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

According to our experience, the treatment with remineralising mousse based on biomimetic nanohydroxyapatite has the advantage of being easily implemented by all patients as it is economical and absolutely noninvasive. The following case report reports the results obtained from the use of a mousse based on biomimetic nanohydroxyapatite for the treatment of incisor and molar hypomineralisation. This case report illustrates the case of a 4-year-old patient who was diagnosed with MIH and was subjected to remineralising treatments at home for six months, at alternating periods. Throughout the observation period, the painful perception of the lesions was detected through an assessment scale, and the clinical appearance was documented photographically. One year after the diagnosis, all the elements involved no longer showed any symptoms.
Climate control on tree growth at the upper and lower treelines: a case study in the qilian mountains, tibetan plateau
Authors: Bao Yang, Minhui He, Thomas M Melvin, Yan Zhao, Keith R Briffa
Journal: PLoS One (2013)
MeSH terms: Climate, Ecosystem, Trees / growth & development, Research Support, Non-U.S. Gov't, Air Conditioning, Altitude, Cold Temperature, Juniperus / growth & development, Temperature

It is generally hypothesized that tree growth at the upper treeline is normally controlled by temperature while that at the lower treeline is precipitation limited. However, uniform patterns of inter-annual ring-width variations along altitudinal gradients are also observed in some situations. How changing elevation influences tree growth in the cold and arid Qilian Mountains, on the northeastern Tibetan Plateau, is of considerable interest because of the sensitivity of the region's local climate to different atmospheric circulation patterns. Here, a network of four Qilian juniper (Sabina przewalskii Kom.) ring-width chronologies was developed from trees distributed on a typical mountain slope at elevations ranging from 3000 to 3520 m above sea level (a.s.l.). The statistical characteristics of the four tree-ring chronologies show no significant correlation with increasing elevation. All the sampled tree growth was controlled by a common climatic signal (local precipitation) across the investigated altitudinal gradient (520 m). During the common reliable period, covering the past 450 years, the four chronologies have exhibited coherent growth patterns in both the high- and low-frequency domains. These results contradict the notion of contrasting climate growth controls at higher and lower elevations, and specifically the assumption that inter-annual tree-growth variability is controlled by temperature at the upper treeline. It should be stressed that these results relate to the relatively arid conditions at the sampling sites in the Qilian Mountains.
A Novel Mutation in the FYCO1 Gene Causing Congenital Cataract: Case Study of a Chinese Family
Authors: Shuping Mei, Jingwei Lin, Zhen Liu, Cheng Li
Journal: Dis Markers (2022)
MeSH terms: Cataract / congenital, Cataract / genetics, Cataract / metabolism, Codon, Nonsense, Microtubule-Associated Proteins / genetics, Asian People / genetics, China, Humans, Mutation, Codon, Nonsense, FYCO1 protein, human, Microtubule-Associated Proteins

Congenital cataract is the most important global cause of visual impairment in children. Autosomal dominant and autosomal recessive inheritance account for the majority of the hereditary nonsyndromic congenital cataract. The function of FYCO1 gene is to guide the transport of the microtubule-directed vesicles. Mutations in the FYCO1 gene may cause cataracts. We reported a novel nonsense mutation in FYCO1 (c.1411C > T, P. R471 ∗), which could cause nonsyndrome autosomal recessive congenital cataract. We underwent an ophthalmology examination of all participants and collected blood samples from all participants and extracted genomic DNAs. By whole exome sequencing, we found that this family carried an unreported mutation in the FYCO1 gene: c.1411C > T, P. R471 ∗. Sanger sequencing was performed to verify the mutation. We used ITASSER and PYMOL to predict and compare the structure and function of the mutated proteins. Using SIFT software and referring to the relevant guidelines of ACMG, the mutation was determined to be pathogenic. The models suggested that the nonsense mutation p.R471∗ resulted in a profound disruption of the FYCO1 protein structure. This report expands the locus information of the FYCO1 mutations.
Case Report: Psychotherapy of a 10-year-old Afghani refugee with post-traumatic stress disorder and dissociative absences
Authors: Nastia Junod, Olga Sidiropoulou, Daniel S Schechter
Journal: Front Psychiatry (2022)
Keywords: dissociation, intersubjectivity, post-traumatic play, post-traumatic stress disorder (ptsd), psychotherapy, refugee mental health
MeSH terms: Case Reports

Violence-related post-traumatic stress disorder (PTSD) in the context of war and terrorism has become an increasingly pressing public health issue relevant to refugee children and families. PTSD and related psychopathology in children can adversely affect all domains of development and, in particular, interfere with learning and socialization. When the experience of violent trauma and related loss is shared with the entire family, resulting impairment and distress may prevent caregivers from being psychologically available to process their traumatized children's emotional communication and otherwise meet their children's developmental needs. When children suffer from PTSD, it may be impossible to put their experience and related thoughts and feelings into words, let alone a coherent narrative. The latter difficulty can be even more pronounced when the child displays dissociative symptoms, possibly signaling a dissociative subtype of PTSD. Thus, the narrative within the child's play during psychotherapy becomes all the more important as an indicator of the child's internal world. This case report is an example both of evaluation and of psychotherapy that is both psychodynamic and trauma-informed with a 10-year-old Afghani boy who suffered the violent loss of his father at age of 3 years, leading to his immigration to Switzerland. This paper addresses the question of how the psychotherapist can accompany the child through the elaboration of his trauma and how the therapist can contribute to the co-construction of a coherent narrative of the child's experience and to the restoration of an intersubjective connection between the traumatized child and caregiver.
Structural Heart Interventions in the Elderly Population
Authors: Devang S Parikh
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: aortic stenosis, transcatheter aortic valve implantation, valvular heart disease
MeSH terms: Aortic Valve Stenosis / diagnostic imaging, Aortic Valve Stenosis / surgery, Heart Valve Prosthesis Implantation / adverse effects, Transcatheter Aortic Valve Replacement / adverse effects, Case Reports, Aged, Aged, 80 and over, Aortic Valve / diagnostic imaging, Aortic Valve / surgery, Female, Humans, Risk Factors, Treatment Outcome

Aortic stenosis is the most common valvular heart disease in the elderly population. Since the advent of transcatheter aortic valve implantation (TAVI) in 2002, the clinical indications for this alternative to a surgical replacement have continually expanded. While the treatment of octo- and nonagenarians can present significant challenges, here we present a case of TAVI in an elderly patient. Given her suitable anatomy and active lifestyle that had been limited by her disease state, the patient successfully underwent TAVI 3 weeks later and was discharged post-operative day 1. This case is the basis for providing five key points to remember about the work-up for TAVI for severe aortic stenosis in the elderly population.
Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis
Authors: Chee Sian Kuan, Su Mei Yew, Yue Fen Toh, Chai Ling Chan, Soo Kun Lim, Kok Wei Lee, Shiang Ling Na, Chee-Choong Hoh, Wai-Yan Yee, Kee Peng Ng
Journal: PLoS One (2015)
MeSH terms: Ascitic Fluid / microbiology, Basidiomycota / isolation & purification, Basidiomycota / pathogenicity, Mycoses / microbiology, Peritoneal Dialysis / adverse effects, Peritonitis / microbiology, Case Reports, Research Support, Non-U.S. Gov't, Basidiomycota / classification, DNA, Fungal / genetics, Drug Resistance, Fungal, Humans, Male, Metabolome, Middle Aged, Mycological Typing Techniques, Phylogeny, DNA, Fungal

Peritonitis is the leading complication of peritoneal dialysis, which is primarily caused by bacteria rather than fungi. Peritonitis is responsible for approximately 18% of the infection-related mortality in peritoneal dialysis patients. In this paper, we report the isolation of a rare fungus, Quambalaria cyanescens, from the peritoneal fluid of a man after he switched from continuous ambulatory peritoneal dialysis to nocturnal intermittent peritoneal dialysis. Based on the morphological examination and multigene phylogeny, the clinical isolate was confirmed as Q. cyanescens. This pathogen exhibited low sensitivity to all tested echinocandins and 5-flucytosine. Interestingly, morphological characterization revealed that Q. cyanescens UM 1095 produced different pigments at low temperatures (25°C and 30°C) on various culture media. It is important to monitor the emergence of this rare fungus as a potential human pathogen in the tropics. This study provides insight into Q. cyanescens UM 1095 phenotype profiles using a Biolog phenotypic microarray (PM). Of the 760 nutrient sources tested, Q. cyanescens UM 1095 utilized 42 compounds, and the fungus can adapt to a broad range of osmotic and acidic environments. To our knowledge, this is the first report of the isolation of Q. cyanescens from peritoneal fluid, revealing this rare fungus as a potential human pathogen that may be misidentified using conventional methods. The detailed morphological, molecular and phenotypic characterization of Q. cyanescens UM 1095 provides the basis for future studies on its biology, lifestyle, and potential pathogenicity.
Outcomes of treatment of severe COVID-19 pneumonia with tocilizumab: a report of two cases from Tunisia
Authors: Mouna Ben Azaiz, Bassem Chatbri, Walid Sellami, Chihebeddine Romdhani, Khaled Lamine, Ezzedine Ghazouani, Ridha Oueslati, Hedi Gharsallah, Mustapha Ferjani
Journal: Pan Afr Med J (2021)
Keywords: covid-19 infection, case report, cytokine storm, interleukin 6, tocilizumab
MeSH terms: COVID-19 Drug Treatment, Case Reports, Antibodies, Monoclonal, Humanized, Humans, SARS-CoV-2, Treatment Outcome, Tunisia, Antibodies, Monoclonal, Humanized, tocilizumab

The SARS CoV-2 pandemic is a global health threat with high morbidity and mortality (1 to 4%) rates. COVID-19 is correlated with important immune disorders, including a "cytokine storm". A new therapeutic approach using the immunomodulatory drug, Anti-IL6 (tocilizimub), has been proposed to regulate it. We report here the first Tunisian experience using tocilizimub in two severe cases of COVID-19 pneumonia. The diagnosis was confirmed by chest scan tomography. Biological parameters showed a high level of Interleukin-6 (IL-6) that increased significantly during hospitalization. The patients developed hypoxia, so they received intravenously 8 mg/kg body weight tocilizumab. There was a resultant decrease in the level of IL6, with clinically good evolution. Blocking the cytokine IL-6 axis is a promising therapy for patients developing COVID-19 pathology.
Different Management Options for Transplant Ureteral Obstructions within an Inguinal Hernia
Authors: Felix Cheung, Merrit Marion Debartolo, Leonard Michael Copertino, April Adams Szafran, Chelsea Caron Estrada, Patrick Gerard Lynch, Frank Sam Darras
Journal: Case Rep Transplant (2016)

Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement. Both patients continued to do well postoperatively with normalization of renal function on follow-up.
Difficult Internal Jugular Central Venous Cannulation Using J-Tip Guidewire with Indwelling Peripherally Inserted Central Venous Catheters
Authors: Preeti Anand, Minal Joshi, Khaja Ahmed, Joel Yarmush
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

Central venous cannulation is a commonly performed procedure while managing critically ill patients; increasingly we encounter patients with indwelling wires or devices, like pacemakers, implantable cardioverter defibrillator devices, and peripherally inserted central venous catheters which complicate insertion of central venous catheters further. We present two cases where use of standard J-tip guidewire may have exacerbated the difficulty associated with internal jugular cannulation in presence of peripherally inserted central venous catheters. Recognition and avoidance of possible complications are crucial, and we discuss complexity posed by indwelling peripherally inserted central venous catheters and possible solutions.
Acute spontaneously resolving pulmonary vasculitis: a case report
Authors: James B Geake, Graeme Maguire
Journal: Case Reports Immunol (2012)

This is the first description that we are aware of describing the spontaneous resolution of an acute pulmonary vasculitis, possibly secondary to microscopic polyangiitis. Haemoptysis is a common symptom for patients presenting to primary and tertiary referral centres, and pulmonary vasculitis is one of a variety of aetiologies that should always be considered. The pulmonary vasculitides are difficult diagnostic and management problems. They are encumbered by a relative paucity of level 1 evidence addressing their diagnosis, classification, and treatment. This is therefore an important paper to publish because it adds to the global breadth of experience with this important clinical condition.
Chondroid and osseous metaplasia in an incidental type II papillary renal cell carcinoma with extensive solid areas: an unraveled molecular character
Authors: Ayesha Ahmed
Journal: Pan Afr Med J (2018)
Keywords: renal cell carcinoma, cytogenetic, papillary
MeSH terms: Carcinoma, Renal Cell / diagnosis, Kidney Neoplasms / diagnosis, Ossification, Heterotopic / diagnosis, Case Reports, Carcinoma, Renal Cell / pathology, Carcinoma, Renal Cell / surgery, Humans, Kidney Neoplasms / pathology, Kidney Neoplasms / surgery, Male, Metaplasia / pathology, Nephrectomy / methods, Ossification, Heterotopic / pathology, Young Adult

Chondroid and osseous metaplasia in a Type II Papillary renal cell carcinoma (PRCC) with extensive solid areas is a complex histological combination that has not been reported before. A 21 years old male presented with a comminuted fracture of right femur. On hematological investigations he was found to have low RBC count and hemoglobin. Radiological examination revealed an incidental, exophytic complex solid and cystic, mass lesion measuring 7 x 6.5 x 4.9 cm with thickened walls, septation and calcification. It was completely replacing upper pole of the left kidney with extension into perinephric fat. Enlarged para aortic and hilar nodes with necrosis were also noted. Radiological diagnosis was infectious processes such as tuberculosis versus malignancy. Surgical intervention comprising left partial nephrectomy was done. Histopathology and immunohistochemical analysis yielded the above diagnosis. Cytogenetic studies did not reveal gain of chromosome 7 and/or 17 or loss of chromosome Y, a characteristic genetic profile of PRCC. This case could be representative of a unique histological variant of PRCC in which the molecular profile yet needs to be unraveled.
Vitrectomy for bilateral macular schisis without apparent optic disc anomalies
Authors: José Andonegui, José Ramón Maya, Marta Echeverría, Araceli Alcaine
Journal: GMS Ophthalmol Cases (2016)
Keywords: macular schisis, optic disc, vitrectomy
MeSH terms: Case Reports

A 78-year-old man complained of bilateral visual acuity loss. Optical coherence tomography examination showed bilateral macular schisis with fluid accumulation in the external retinal layers without vitreous traction. Fundus examination and fluorescein angiography were normal in both eyes. Both eyes were treated by phacoemulsification, intraocular lens implantation, and vitrectomy without laser, gas exchange, or retinal fenestration. Slow and progressive fluid resorption and improvement in VA were observed in both eyes. Macular schisis similar to the one associated with optic disc anomalies is a possibility in patients without apparent disc anomalies. Vitrectomy without laser, gas, or retinal fenestration may be a good therapeutic option even in patients with a PVD preoperatively.
Transabdominal supra-diaphragmatic self-attached mesh for recurrent type IV diaphragmatic hernia on emergency setting: Case report
Authors: Adeodatus Yuda Handaya, Aditya Rifqi Fauzi, Victor Agastya Pramudya Werdana
Journal: Int J Surg Case Rep (2019)
Keywords: diaphragmatic hernia, recurrence, self-attached mesh, supradiaphragmatic, trans abdominal

Introduction:
Adult diaphragmatic hernia is a rare case and usually present with various clinical manifestations. Surgery can be done by thoracic and abdominal approaches. In emergency cases, mostly performed by abdominal approach. The use of mesh to close the defect is currently emerging as a viable option.
Presentation of case:
We report a case of 70-year-old woman with complaints of shortness of breath and abdominal pain. The patient had a history of laparoscopic surgery with the installation of an anti-adhesive mesh for diaphragmatic hernia seven months before admission. Chest X-ray and Computed Tomography (CT) scan found recurrence of diaphragmatic hernia. The patient then received laparotomy showing diaphragmatic hernia with contents in the form of transverse colon, ileum, gastric and omentum. The self-attached mesh was placed on the supra-diaphragm with abdominal approach. The patient was hospitalised four days after surgery. At two weeks and six months follow-up, no complaints were found. CT scan and chest X-ray were within normal limits.
Discussion:
We did a modified technique in managing the recurrence and adhesion of the diaphragmatic hernia using the hernia mesh attached onto the superior side of the diaphragm to minimise the complications and recurrences.
Conclusions:
Transabdominal supradiaphragmatic self-attached mesh for recurrent diaphragmatic hernia can be considered to be an alternative treatment for recurrent diaphragmatic hernia in an emergency setting because this procedure is relatively easier, safer, causes fewer postoperative complications, and can prevent recurrence.
Phthisis Bulbi in a Retinitis Pigmentosa Patient after Argus II Implantation
Authors: Logan Vander Woude, Ramak Roohipour, Gibran Syed Khurshid
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
To report a previously unreported complication of phthisis after Argus II prosthesis implantation in a retinitis pigmentosa (RP) patient.
Case:
A 61-year-old male with advanced RP presented to the retina clinic. The patient had a history of vitrectomy in both eyes (OU) in Cuba in 1996. Pre-op visual acuity (VA) was no light perception (NLP) in the right eye and light perception (LP) in the left eye. The patient met the criteria for Argus II implantation and elected to proceed with surgery in his left eye in December 2017. The surgical implantation of the Argus II was successful without any complications. On postoperative day 1, his VA was stable at LP. He was satisfied with his ambulatory vision after the electrodes were turned on. Four months after surgery, the patient was complaining of aching pain; he was found to have preseptal cellulitis and was started on antibiotics. This swelling improved over two weeks, but when the patient returned, he had a two mm hyphema associated with mild ocular inflammation without an inciting event or reason on exam. The hyphema was treated and resolved after two weeks. However, one month after the hyphema resolved, at postoperative month six, the patient's vision in his left eye became NLP and began to demonstrate phthisical changes, including hypotony, Descemet membrane folds, and a vascular posterior capsular membrane. Discussion. The theoretical causes of phthisis bulbi after Argus II implantation include fibrous downgrowth, ciliary shut down due to immune reaction, inflammation, or trauma. While the cause of phthisis in this Argus patient is not certain and possibly multifactorial, it is important to note that phthisis is a possible complication of an Argus II implant, as this patient had no other obvious insult or reason for the phthisical change.