OpenMed/multicare-articles huggingface dataset:
Disorders of sodium balance in COVID-19 patients: two Tunisian patients report
Authors: Ghada Saad, Asma Ben Abdelkrim, Yosra Hasni El Abed, Soumaya Tahri, Asma Gorchene, Amel Maaroufi, Molka Chadli, Maha Kacem Njah, Koussay Ach
Journal: Pan Afr Med J (2021)
Keywords: covid-19, hyponatremie, sars-cov-2, tunisia, hypernatremie
MeSH terms: COVID-19 / complications, Hypernatremia / virology, Inappropriate ADH Syndrome / virology, Case Reports, Aged, Fatal Outcome, Humans, Hypernatremia / diagnosis, Hyponatremia / diagnosis, Hyponatremia / virology, Inappropriate ADH Syndrome / diagnosis, Male, Sodium / blood, Sodium

Coronavirus disease 2019 (COVID-19) was first reported in December 2019. The disease is caused by severe acute respiratory syndrome virus corona virus 2 (SARS-CoV-2). Mild respiratory symptoms are the most common manifestations of SARS-CoV-2, but new signs are constantly being discovered as it spreads. Disorders of sodium balance are increasingly described in patients with SARS-CoV-2. We report, here, the cases of two patients presented with COVID-19 and in whom we discovered sodium disorders. The first patient is a 74-year-old man who presented with fatal hypernatremia. The second patient is a 66-years-old man presented with COVID-19 and euvolemic hyponatremia attributed to syndrome of inappropriate anti-diuretic hormone secretion (SIADH). This hyponatremia persisted long after the respiratory signs disappeared. Sodium balance disorders are increasingly described in the literature; special attention should be paid to the electrolyte status of COVID-19 patients. Pathophysiological mechanisms associating SARS-CoV-2 with these disorders are being studied.
Delayed airway obstruction after internal jugular venous catheterization in a patient with anticoagulant therapy
Authors: Pei-Ju Wu, Siu-Wah Chau, I-Cheng Lu, Hung-Te Hsu, Kuang-I Cheng
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

Delayed onset of neck hematoma following central venous catheterization without arterial puncture is uncommon. Herein, we present a patient who developed a delayed neck hematoma after repeated attempts at right internal jugular venous puncture and subsequent enoxaparin administration. Progressive airway obstruction occurred on the third day after surgery. Ultrasound examination revealed diffuse hematoma of the right neck, and fibreoptic examination of the airway revealed pharyngeal edema. After emergent surgical removal of the hematoma, the patient was extubated uneventfully.
Important functional distress in a teenager with optic nerve drusen
Authors: Alina Simona Lazar, Simona Stanca, T Horia Stanca
Journal: Rom J Ophthalmol (2019)
Keywords: optic nerve drusen, optic nerve pathology, perimetry, pseudopapilledema, visual field defects
MeSH terms: Optic Disk Drusen / diagnosis, Papilledema / diagnosis, Scotoma / diagnosis, Visual Acuity, Visual Fields / physiology, Case Reports, Adolescent, Female, Humans, Optic Disk, Optic Disk Drusen / physiopathology, Papilledema / etiology, Papilledema / physiopathology, Scotoma / etiology, Scotoma / physiopathology, Tomography, Optical Coherence, Ultrasonography, Visual Field Tests

We present a case of bilateral optic disc drusen and severe visual field loss in a female patient diagnosed at a very young age.
Oculogyric Crisis after Initiation of Aripiprazole: A Case Report of an Active Duty Service Member
Authors: Nicole L Hadler, Yevin A Roh, David A Nissan
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Introduction:
Oculogyric crisis is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes. It is a relatively uncommon extrapyramidal side effect of antipsychotic medications. Aripiprazole is an atypical antipsychotic that is FDA-approved for the treatment of schizophrenia, bipolar disorder, Tourette's disorder, and treatment resistant major depressive disorder. Compared to other antipsychotics, it is thought to have a lower propensity for causing dystonic side effects. Clinical Case. This case report is of a 19-year-old male who was psychiatrically hospitalized for first episode psychosis and initiated on low-dose oral aripiprazole. Three days after initiation of the medication, the patient was found to be markedly anxious and pacing around his room. Exam was notable for intermittent upward eye rolling, sustained upward conjugate gaze, and limited downward gaze. No other facial dyskinetic movements were observed. Treatment. The patient's oral aripiprazole was held, and he was administered 50 mg of oral diphenhydramine with improvement in symptoms within one hour. Ocular symptoms, dizziness, frontal headache, and pacing were resolved the following morning. He declined reinitiation of an antipsychotic medication.
Conclusion:
Aripiprazole-induced acute dystonia, specifically OGC, is a rare potential adverse effect of aripiprazole. Risk factors include male gender, young age, use of typical antipsychotics, and initiation or uptitration of an antipsychotic. Even though atypical antipsychotics including aripiprazole are associated with lower risk for extrapyramidal symptoms, the possibility of oculogyric dystonia merits close monitoring especially in young, male, and drug naive patients. Anticholinergic agents such as diphenhydramine can treat symptoms of acute dystonia.
Neglected rupture of the quadriceps tendon in a patient with chronic renal failure (case report and review of the literature)
Authors: Zouhir Ameziane Hassani, Moncef Boufettal, Moustapha Mahfoud, Moradh Elyaacoubi
Journal: Pan Afr Med J (2014)
Keywords: quadriceps tendon, lengthening plasty, renal failure, spontaneous rupture
MeSH terms: Kidney Failure, Chronic / complications, Pain / etiology, Tendon Injuries / etiology, Case Reports, Review, Adult, Humans, Magnetic Resonance Imaging / methods, Male, Quadriceps Muscle, Rupture, Tendon Injuries / pathology, Tendon Injuries / surgery

Spontaneous ruptures of the quadriceps tendon are infrequent injuries, it is seen primarily in patients with predisposing diseases such as gout, rheumatoid arthritis and chronic renal failure. A 32-year-old man had a history of end stage renal disease and received regular hemodialysis treatment for more than 5 years. He was admitted in our service for total functional impotence of the right lower limb with knee pain after a common fall two months ago. The radiogram showed a ''patella baja" with suprapatellar calcifications. The ultrasound and MRI showed an aspect of rupture of the quadriceps tendon in its proximal end with retraction of 3 cm. Quadriceps tendon repair was performed with a lengthening plasty, and the result was satisfactory after a serial rehabilitation program. The diagnosis of quadriceps tendon ruptures needs more attention in patients with predisposing diseases. They should not be unknown because the treatment of neglected lesions is more difficult. We insist on the early surgical repair associated with early rehabilitation that can guarantee recovery of good active extension.
Clinical Characteristics and Surgical Procedures for Children with Congenital Membranous Cataract
Authors: Jingji Long, Daoman Xiang, Zheng Guo, Lihong Chen, Feng Chen, Jianxun Wang, Wanhua Xie, Shiping He
Journal: J Ophthalmol (2017)

Objective:
In a group case series, the clinical characteristics of congenital membranous cataract in children were studied to establish a system of classification and determine the surgical method suited for each type.
Methods:
Children (18 eyes) with congenital membranous cataract were examined by slit lamp, ultrasound biomicroscopy, and operating microscopy to classify cataracts. The clinical characteristics of congenital membranous cataract and its feature related to the surgical method were analyzed.
Results:
Five major types of congenital membranous cataracts were classified. All of the surgeries were successful. Anterior and posterior capsulorhexis was performed using Klöti RF capsulotomy tips. The capsular flap was removed, and anterior vitrectomy was performed using a vitrectomy cutter. Postoperative complications included posterior capsule opacification in 16.7% of the patients.
Conclusion:
Ultrasound biomicroscopy was used successfully to classify congenital membranous cataracts prior to surgery. Anterior and posterior capsulorhexis was performed using Klöti RF capsulotomy tips, and capsulectomy was performed using a vitrectomy cutter. These were effective techniques and should be considered for congenital membranous cataract removal surgery. This trial is registered with registration number chiCTR-OOC-17010913.
Conservative treatment of acute traumatic left renal vein occlusion: Importance of left gonadal vein, case report
Authors: Hyung Jun Kwon, Kyoung Hoon Lim
Journal: Int J Surg Case Rep (2020)
Keywords: acute occlusion, collateral, gonadal vein, left renal vein, traumatic
MeSH terms: Case Reports

Introduction:
Isolated acute traumatic renal vein occlusion is rare. As both kidneys have limited capsular and peripelvic vein collaterals, acute renal vein occlusion could lead to renal infarction. However, the left renal vein has potential collateral pathways through the gonadal vein.
Presentation of case:
A 56-year-old woman was transferred to our trauma center after a pedestrian accident. Computed Tomography (CT) with contrast enhancement showed that no delineation of left renal vein with adjacent retroperitoneal hematoma around renal vessels, but left renal venous flow was being drained through left gonadal vein, therefore, left kidney was not congested. Her serum creatinine concentration was normal. We elected to treat her left renal vein occlusion conservatively because of the collateral pathway into the gonadal vein.
Discussion:
Collateral pathway of the left renal venous drainage may be well known to urologists or vascular surgeons, but may be unfamiliar to trauma surgeons. Therefore, trauma surgeon's attempts for revascularization of thrombosed left renal vein may lead to massive bleeding or nephrectomy.
Conclusion:
Acute left renal vein occlusion close to the inferior vena cava can result in temporary venous hypertension and congestion followed by complete or nearly complete return of function as collateral veins enlarge. If the gonadal vein is patent, left renal vein occlusion could be treated conservatively.
p.Gly743Val Mutation in COL4A1 Is Responsible for Familial Porencephaly and Severe Hypermetropia
Authors: Pasquale Scoppettuolo, Noémie Ligot, Vanessa Wermenbol, Patrick Van Bogaert, Gilles Naeije
Journal: Front Neurol (2020)
Keywords: col4a1, type iv collagen, familial porencephaly, ocular malformations, variable expressivity
MeSH terms: Case Reports

COL4A1 is an essential component for basal membrane stability. Exon mutations of the COL4A1 genes are responsible for a broad spectrum of cerebral, ocular, and systemic manifestations. We describe here the phenotype of a likely pathogenic gene variant, p.Gly743Val, which is responsible for a missense mutation in the COL4A1 gene exon 30 in a three generation family with severe hypermetropia and highly penetrant porencephaly in the absence of systemic manifestations. This report highlights both the broad spectrum of COL4A1 mutations and the yield of testing the COL4A1 gene in familial ophthalmological and brain disorders.
Case Report: Refractory Cytopenia With a Switch From a Transient Monosomy 7 to a Disease-Ameliorating del(20q) in a NHEJ1-Deficient Long-term Survivor
Authors: Fiona Poyer, Raúl Jimenez Heredia, Wolfgang Novak, Petra Zeitlhofer, Karin Nebral, Michael N Dworzak, Oskar A Haas, Kaan Boztug, Leo Kager
Journal: Front Immunol (2022)
Keywords: nhej1, nhej1-deficiency, del(20q), monosomy 7, myelodysplastic syndrome, refractory cytopenia
MeSH terms: Hematopoietic Stem Cell Transplantation, Myelodysplastic Syndromes / genetics, Case Reports, Child, Preschool, Chromosome Deletion, Chromosomes, Human, Pair 7, DNA Repair Enzymes / genetics, DNA-Binding Proteins / genetics, Humans, Male, Survivors, DNA-Binding Proteins, NHEJ1 protein, human, DNA Repair Enzymes, Chromosome 7, monosomy

We report the case of a male Pakistani patient with a pathogenic homozygous loss of function variant in the non-homologous end-joining factor 1 (NHEJ1) gene. The growth retarded and microcephalic boy with clinodactyly of both hands and hyperpigmentation of the skin suffered from recurrent respiratory infections. He was five and a half years old when he came to our attention with refractory cytopenia and monosomy 7. Hematopoietic stem cell transplantation was considered but not feasible because there was no suitable donor available. Monosomy 7 was not detected anymore in subsequent bone marrow biopsies that were repeated in yearly intervals. Instead, seven and a half years later, a novel clone with a del(20q) appeared and steadily increased thereafter. In parallel, the patient's blood count, which had remained stable for over 20 years without necessitating any specific therapeutic interventions, improved gradually and the erythropoiesis-associated dysplasia resolved.
Conjoined twins-thoraco-omphalopagus (type A)
Authors: Omar Muayad Sultan, Ahmed Said Tawfeek
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

A case of conjoined twins discovered by routine transabdominal ultrasound examination at 16 weeks gestation in a 19-year-old multigravid female. They were joined at the chest and the abdomen and had one functional heart. The pregnancy was terminated by caesarean section at 19 weeks gestation with approval from the family.
Case Report: Eosinophilic gastritis with pyloric stenosis in immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome
Authors: Ronghua Yu, Yongmei Xiao, Wuhen Xu, Ting Zhang, Yizhong Wang, Hui Hu
Journal: Front Pediatr (2022)
Keywords: foxp3, hsct, ipex, eosinophilic gastritis, pyloric stenosis
MeSH terms: Case Reports

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare X-linked recessive immunodeficiency caused by mutations in the forkhead box protein 3 (FOXP3) gene. IPEX is characterized by the onset of intractable diarrhea, type 1 diabetes mellitus (T1DM), and eczema in the early stages of life. The typical clinic triad for IPEX is not always seen. Here, we report a 15-year-old male patient with atypical IPEX syndrome complicated with severe eosinophilic gastritis (EG) and pyloric stenosis. The patient had noticeable eczema during the first year of life and had a history of food allergies. At the age of 3 years, the patient was diagnosed with EG, Helicobacter pylori (HP) infection, pyloric stenosis with recurrent vomiting, and failure to thrive. The patient did not respond to long-term symptomatic treatments in the following years, including methylprednisolone, proton pump inhibitors (PPI), L-glutamine and sodium gualenate granules, anti-HP therapy, and balloon dilation. At the age of 12 years, the patient received surgical interventions, including a laparoscopic jejunostomy feeding tube placement, gastrojejunal anastomosis bypass, and jejunal-jejunal end-to-side anastomosis. Intractable diarrhea and T1DM were not present in the patient. At the age of 14 years, the patient was diagnosed with IPEX syndrome due to a c.748-750del (p.Lys250del) mutation in the leucine zipper domain of the FOXP3 protein. The patient underwent matched sibling peripheral blood hematopoietic stem cell transplantation (HSCT) and showed good evolution after 3 months of HSCT. In summary, this case report provides information of unusual gastrointestinal findings in IPEX syndrome and highlights the need for increased awareness and early diagnosis of IPEX syndrome, which is vital for improving the patient's outcome.
Fetal spina bifida in a pregnant woman following omega gastric bypass: Case report and literature review
Authors: Lionel El Khoury, Rosa Benvenga, Joel Roussel, Rodolfo Romero, Regis Cohen, Nassir Habib, Jean-Marc Catheline
Journal: Int J Surg Case Rep (2020)
Keywords: bariatric surgery, congenital malformations, neural tube defects, obesity, omega gastric bypass, pregnancy
MeSH terms: Case Reports

Introduction:
Bariatric surgery has been increasingly popular during the last years because of its proven efficacy on obesity and related complications. However, nutrient deficiency is common after surgery, in particular after Roux-en-Y gastric bypass (RYGB) or omega gastric bypass (OGB), due to iatrogenic malabsorption. All vitamins and minerals could be involved, including vitamin B9 which plays an important role in the prevention of neural tube defects during pregnancy. We present a case of a spina bifida in the fetus of a pregnant woman following OGB.
Case presentation:
A twenty-six years old young woman underwent OGB five years after weight loss failure post sleeve gastrectomy. Her initial body mass index (BMI) was 42.7 kg/m2. Two years after OGB, she became pregnant. On her gynecologist's advice, the patient discontinued daily vitamin intake before the end of the first trimester, as obstetrical follow-up had been considered appropriate. Regrettably, second trimester ultrasound showed myelomeningocele and surgical abortion was decided during the 25th week of pregnancy.
Discussion:
Nutritional status in a pregnant woman is crucial, since it determines the fetal outcome. Biochemical and ultrasound monitoring should be performed regularly, especially in pregnant women with a history of bariatric surgery.
Conclusion:
Vitamins, minerals and trace metals deficiencies after bypass bariatric surgery could be prevented by adequate supplementation administered before and during pregnancy.
Penetrating corneal wound with traumatic cataract and intraocular foreign body-case report
Authors: Dorin Căciulă, Monica Gavriș, Irina Tămășoi
Journal: Rom J Ophthalmol (2017)
Keywords: cataract, corneal wound, intraocular foreign body, iris-claw intraocular lens
MeSH terms: Cataract / etiology, Cataract Extraction, Corneal Injuries / etiology, Eye Foreign Bodies / etiology, Eye Injuries, Penetrating / etiology, Metals, Case Reports, Cataract / diagnosis, Cataract / therapy, Corneal Injuries / diagnosis, Corneal Injuries / surgery, Eye Foreign Bodies / diagnosis, Eye Foreign Bodies / surgery, Eye Injuries, Penetrating / diagnosis, Eye Injuries, Penetrating / surgery, Humans, Iris / injuries, Lens Implantation, Intraocular, Lens, Crystalline / injuries, Male, Middle Aged, Metals

Open globe injuries complicated with the presence of an intraocular foreign body mostly affect young males and represent a vision threatening condition. We presented the case of a 48-year-old male who presented to our emergency service due to ocular pain and blurred vision in his right eye. A metallic foreign body situated between 1 and 12 o'clock, near the corneoscleral limbus, that perforated the cornea, the iris, the anterior capsule of the lens and the lens, was detected at the slit-lamp examination. We decided to immediately remove the foreign body that was approximately 20 mm long. The following day, traumatic cataract had already developed, so we performed cataract extraction. Despite the dimensions of the intraocular foreign body, the retina was attached and there were no sign of retinal tears or vitreous haemorrhage. The proper management in this case led to good results in spite of the dimensions of the intraocular foreign body. Abbreviations: IOFB = Intraocular Foreign Body, IOL = Intraocular Lens, PVR = Proliferative Vitreo-Retinopathy.
Respiratory Muscle Paralysis Associated With Colistin, Polymyxin B, and Muscle Relaxants Drugs: A Case Report
Authors: Thein Myint, Martin E Evans, Donna R Burgess, Richard N Greenberg
Journal: J Investig Med High Impact Case Rep (2016)
Keywords: colistin, muscle relaxant drugs, polymyxin b, respiratory muscle paralysis

Polymyxins B and E (colistin) exert a bactericidal effect on the gram-negative bacterial cell wall, causing permeability changes in the cytoplasmic membrane, leading to cell death. Their use was substantially decreased in clinical practice from the 1970s to 2000s due to their significant nephrotoxicity and neurotoxicity compared to the newly introduced antibiotics. The increasing prevalence of multidrug-resistant gram-negative bacteria infections in this century has led to an upsurge in the use of these "older" drugs. Respiratory paralysis caused by neuromuscular blockage associated with the use of polymyxin B and E was reported mostly in literature published in the 1960s to 1970s with a few reports after 2000. In addition, such a reaction might be enhanced by the presence of other classes of drugs. We report a case of polymyxin B and E-induced apnea in a patient receiving "muscle relaxants."
Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest
Authors: Jing Zhang, Xun Liu, Mo Zheng, Jing Yin, Weibin Xing
Journal: Front Oncol (2021)
Keywords: contrast-enhanced ultrasound, dermoscopy, diagnosis, high-frequency ultrasound, sweat gland neoplasms, treatment
MeSH terms: Case Reports

This article aims to explain the use of a variety of noninvasive of minimally invasive examinations to obtain reliable diagnostic clues. The choice of treatment methods and repair techniques for wound defects are also critical in terms of the prognosis. Here, we describe the case of a 53-year-old male patient who visited our dermatology clinic due to a red plaque on the inner side of his left nipple without any symptoms for more than 30 years. He was given dermoscopy, high-frequency ultrasound (HFUS), Color Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) examinations. Currently, there are no literatures on these auxiliary examinations for this disease. Dermoscopy revealed that there were abundant blood vessels on the periphery of the skin lesion with obvious dilation. HFUS revealed an inhomegeneous hypoechoic solid mass in the dermis with clear borders and irregular shape. CDFI indicated that there are abundant blood flow signals in the periphery and central of the tumor. CEUS showed a mixed inhomogeneous, grid-like high-enhancement pattern. Based on the above auxiliary findings, the possibility of malignant lesion was suspected. Therefore, the patient was given a pathological examination, which showed that many luminal structures of the dermis layer were embedded in the hyperplastic fibrous tissue. The atypical cells were not obvious but showed an infiltrating growth pattern. Immunohistochemistry showed positive reaction for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA) and a weak positive results was obtained for S-100. There was also a negative result for CK20, gross cystic disease fluid protein 15 (GCDFP-15), and P63. As a result, the patient was diagnosed with "syringoid eccrine carcinoma." The treatment was surgical excision. Mohs microsurgery was combined with the looped, broad, and deep-buried suturing technique (LBD tension-reduced suturing technique). This technique directly sutures the wound instead of carrying out traditional skin grafting or flap transfer. The postoperative follow-up results were satisfactory as no obvious keloid formed on the wound during the follow-ups. In conclusion, ultrasound is greatly advantageous in tumor morphology and hemodynamics. It orients the therapeutic management and assesses the therapeutic efficacy and the tumoral prognosis. In surgical treatments, a less-traumatic operation should be selected to reduce the patient's pain.