OpenMed/multicare-articles huggingface dataset:
Advanced Technique of Unilateral Biportal Endoscopy on Revision Surgery for Recurred Herniated Interverbral Disc: A Technical Note
Authors: Hun-Chul Kim, Jin Young Lee, Hyeon Guk Cho, Jeong Woo Park, Sang-Ho Han, Young-Il Ko
Journal: Case Rep Orthop (2024)
MeSH terms: Case Reports

Introduction: Revision surgery in the spine poses considerable challenges due to the presence of scar tissue and structural differences, necessitating careful surgical planning and precise techniques. In this technical note, we focus on lumbar unilateral biportal endoscopy (UBE) for single-level reoperations, outlining principles and methods for handling soft tissue in such cases. Materials and Methods: We reviewed our surgical approach for lumbar reoperations with UBE, emphasizing the importance of meticulous preoperative planning and bone-centered manipulation. Our technique involves utilizing biportal endoscopy for enhanced visualization and employing specific strategies for managing scar tissue, including the "pull-and-cut technique." We present two illustrative cases to demonstrate the application of our method. Results: The described approach yielded successful outcomes in both cases presented. Case 1 involved a posterior interlaminar approach for a recurrent disc at the L4-5 level, while Case 2 utilized a far lateral approach for recurrent disc herniation at the L4-5 level. Both surgeries were completed with relatively short operation time, minimal blood loss, and immediate improvement in symptoms postoperatively. Conclusion: Lumbar UBE offers a promising option for safe and effective reoperation in spinal surgery. Our technique, emphasizing bone-centered manipulation and specific strategies for scar tissue management, provides excellent visibility and enables precise tissue handling. Overall, UBE facilitates relatively simple and safe reoperations, contributing to improved patient outcomes in the challenging field of spinal surgery.
Case report: Facilitating right heart recovery after durable LVAD implantation through repair of atrioventricular valves and RVAD implantation using tunneled Dacron grafts
Authors: K Candis Jones-Ungerleider, Syed Sikandar Raza, Paul C Tang
Journal: Front Cardiovasc Med (2023)
Keywords: left ventricular assist device, mitral regurgitation, right heart failure, right ventricular assist device, right ventricular dysfunction, tricuspid regurgitation
MeSH terms: Case Reports

Right ventricular assist device (RVAD) weaning is often an important goal for durable left ventricular assist device support. This may be facilitated by mitral and tricuspid repair as well as by minimizing the trauma of RVAD decannulation by using Dacron grafts.
Measuring the Impact of Incorporating Case Study Presentations Into Applied Biomedical Science Placement Workshops for Trainee Biomedical Scientists
Authors: Amreen Bashir, Kathryn Dudley, Karan Singh Rana, Kayleigh Wilkins, Ross Pallett
Journal: Br J Biomed Sci (2024)
Keywords: hcpc sops, ibms registration portfolio, biomedical science, case study presentation, collaborative working

Introduction: Successfully completing the Institute of Biomedical Science (IBMS) registration portfolio is essential to becoming a Health and Care Professions Council (HCPC) registered Biomedical Scientist. In the West Midlands, a unique collaboration between four universities (Aston, Wolverhampton, Coventry, and Keele) and local NHS Trusts supports student placements and portfolio development. The universities support Training Officers in delivering components of the registration portfolio through the delivery of eight combined placement workshops. These have been designed to align to the IBMS registration portfolio and help students meet the HCPC Standards of Proficiency. This study aimed to evaluate the effectiveness of a redesigned workshop where students generated and presented medical case studies to peers, academics, and training leads. Materials and Methods: The three phases of the case study intervention included a pre-intervention survey, academic-led sessions focussing on medical case presentations and delivery of the presentation followed by a post-intervention survey. Results: Analysing survey responses pre- and post-intervention, students demonstrated enhanced confidence in their understanding of clinical conditions (p<0.0001), connecting lab findings to diseases, and in delivering a case presentation to their peers (p<0.001). Students reported an increased confidence in structuring case presentations and their critical thinking ability (p<0.0001). All students agreed engaging with the case study workshop improved their ability to communicate knowledge of scientific concepts orally. Thematic analysis revealed that the case presentation deepened students' understanding of multidisciplinary teams. 98% of respondents agreed patient communication should be integrated into Biomedical Sciences courses and 85% would like to see case study presentations embedded into the curriculum. Discussion: Combined placement workshops are an integral part of the Applied Biomedical Science placement journey. Case study presentations are clearly a valuable teaching and learning tool to nurture and develop key transferable skills and competencies in conjunction with Biomedical Science expertise. The collaborative approach in the West Midlands effectively prepares graduates with essential pathology knowledge, skills, and a completed IBMS registration portfolio. This study highlights a successful framework for a collaborative partnership with local NHS trusts that has allowed the completion of numerous pathology placements and could be adopted by other universities delivering accredited Biomedical Science courses.
Neurological manifestation of Brazilian spotted fever in childhood
Authors: Bruna Fernanda Deicke Mendes, Marina Melo Moreira, Ana Luisa Lodi Jimenez, Lívia Barbosa da Silva, Laura Maria Silva Thiersch, Carolina Malaquias Rodrigues, Bruna Ribeiro Torres, Juliana Goulart Dias da Costa, Lilian Martins Oliveira Diniz
Journal: Rev Inst Med Trop Sao Paulo (2024)
MeSH terms: Rocky Mountain Spotted Fever / complications, Rocky Mountain Spotted Fever / diagnosis, Rocky Mountain Spotted Fever / microbiology, Case Reports, Brazil, Child, Fever, Humans, Rickettsia rickettsii

Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.
Case Report: An unusual case of a transposition of the great arteries with a double aortic arch: a highly complex fetal diagnosis with an unpredictable outcome
Authors: M Masci, A Missineo, C M Campanale, P Moras, M C Colucci, L Pasquini, A Toscano
Journal: Front Cardiovasc Med (2024)
Keywords: double aortic arch, fetal diagnosis, fetal echocardiography, transposition of the great arteries, vascular ring
MeSH terms: Case Reports

Published data estimate the prevalence of the vascular ring at approximately 7 per 10,000 live births. The association of a double aortic arch with a D-transposition of the great arteries has been rarely described in the literature. In this study, we report the prenatal diagnosis of a 28-year-old woman. A fetal echocardiography at a gestational age of 24 weeks + 6 days showed a D-transposition of the great arteries and a double aortic arch with a ventricular septal defect and pulmonary stenosis. On the first night after birth, the baby experienced an increase in lactate levels, with the rate of oxygen saturation consistently below 80%. A few hours after birth, the patient underwent a Rashkind procedure. An echocardiography, CT chest x-ray, and CT angiogram confirmed a diagnosis with a severe reduction of the tracheal lumen (>85%) and bronchomalacia. Then, the patient underwent posterior tracheopexy and aortopexy and later an arterial switch operation, ventricular septal defect closure, and resection of a part of the infundibular septum, accepting the risk of potential neoaortic obstruction. The literature has reported only two cases of patients with a fetal echocardiogram diagnosis. Therefore, our patient is only the third one with a fetal diagnosis and the second one with a complex intracardiac anatomy, characterized not only by a ventricular septal defect but also by two separate components of the obstruction (a bicuspid valve and a dysplastic valve with a posterior deviation of the infundibular septum). In conclusion, a D-transposition of the great arteries with a double aortic arch remains an extremely unusual association. The clinical outcome of these patients presents a high degree of variability and is entirely unpredictable in prenatal life. Our greatest aim as fetal and perinatal cardiologists is to improve the management and outcome of these patients through a fetal diagnosis, recognizing types of congenital heart disease in newborns who require early neonatal invasive procedures.
Biliary Cyst: An Unusual Cause of Cholestasis Post Cholecystectomy
Authors: Mark Ayoub, Carol Faris, Tiana Dodd, Shawn Chillag
Journal: Cureus (2024)
Keywords: biliary cysts, choledochal cysts, endoscopy ercp, hepato biliary cancers, jaundice cholestatic, magnatic resonance cholangiopancreaticography(mrcp), obstructive jaundice, post cholecystectomy complications, right upper quadrant abdominal pain, roux-en-y hepaticojejunostomy
MeSH terms: Case Reports

Biliary cysts are relatively uncommon and they can be congenital or acquired and can have various presentations such as cholelithiasis, cholangitis, jaundice, and pancreatitis. Biliary cysts are associated with a high risk of biliary cancers and such risk increases with age. Identification of biliary cysts warrants an aggressive approach to lower cancer risk. Surgical management has a high success rate and it lowers morbidity, mortality, and cancer risk. We present a 40-year-old female who had a cholecystectomy in 2016. She presented with obstructive jaundice and was found to have a class I biliary cyst. She underwent endoscopic retrograde cholangiopancreatography with stenting which led to complete resolution of her symptoms. Later, she underwent elective Roux-en-Y hepaticojejunostomy with cyst resection three months later. She underwent a successful recovery.
Diagnosis and Management of Patients with Connective Tissue Disease-related Fibrosing Interstitial Lung Diseases
Authors: Bonnie Wang, Vivek Nagaraja
Journal: Open Respir Med J (2023)
Keywords: autoimmune disease, connective tissue disease, diagnosis, fibrosis, interstitial lung disease, lung
MeSH terms: Case Reports

Background:
Fibrotic interstitial lung disease is an important driver of morbidity and mortality in patients with connective tissue diseases (CTD). Due to the lack of prospective randomized trial data in this population, practice pattern variation exists in the management of patients with CTD.
Case presentation:
This case series describes three patients, each with a different background of autoimmunity complicated by fibrotic interstitial lung disease (ILD). We review their initial presentations, follow their disease trajectories on currently available treatments, and reference forthcoming clinical trials.
Conclusion:
Clinical impact or potential implications. Response to immunosuppression and antifibrotic therapy is variable in patients with connective tissue disease-related fibrosing interstitial lung disease. Data from prospective clinical trials and longitudinal registry studies will conceivably provide additional insight into improving care for these patients.
Idiopathic young-onset Fahr's disease with schizophrenia-like presentation: a case report
Authors: Wen-Cheng Li, Ya-Chu Hsieh, Pei-Ting Chen, Chia-Ning Lee, Tsung-Yu Tsai
Journal: Front Psychiatry (2024)
Keywords: fahr’s disease, adolescent psychosis, aggression, basal ganglia calcification, schizophrenia
MeSH terms: Case Reports

This case report describes an exceptionally rare case in which a prior diagnosis of schizophrenia was later determined to be early-onset Fahr's disease, linked to a genetic mutation in the SLC20A2 gene. Initially, the patient exhibited symptoms resembling schizophrenia, including aggression and hostility, and was highly susceptible to medication side effects such as restlessness and Parkinsonism. Despite maintaining independent activities of daily living, his neurological examinations revealed hidden weakness on the left side. Following adjustments to the medication regimen, stability was achieved with residual psychotic symptoms under treatment with Risperidone 1.5mg/day, Valproic acid 1500mg/day, and Quetiapine 37.5mg/day. This case underscores the importance of conducting comprehensive imaging studies at the time of initial psychiatric diagnosis, regardless of the apparent typicality of the presentation. Additionally, it emphasizes the need for patience and adherence to the "Start Low and Go Slow" approach in medication management to minimize the risk of exacerbating psychiatric symptoms and aggression.
Laser balloon ablation of atrial fibrillation in a patient with a large common inferior trunk: a case report
Authors: Tomohiro Takiguchi, Masao Takemoto, Tokushi Koga, Takuya Tsuchihashi
Journal: Eur Heart J Case Rep (2024)
Keywords: atrial fibrillation, case report, catheter ablation, common inferior trunk, laser balloon
MeSH terms: Case Reports

Background:
A balloon-based visually guided laser balloon (LB) ablation (LBA) is as effective and safe as radiofrequency ablation and cryoballoon ablation in curing patients with atrial fibrillation (AF). The third-generation LB is so compliant that it can be inflated to any pressure and size change of up to 41 mm with its maximal expansion, which enables maximum balloon/tissue contact regardless of the size or shape of each pulmonary vein (PV) ostium. A large common inferior trunk (CIT) with a structured, completely independent common ostium of both the right and the left inferior PVs completely conjoined prior to the junction with the left atrium is an extremely rare anatomical variant and an important triggering focus in paroxysmal AF.
Case summary:
We present a case of an LBA of AF in a patient with a large CIT of 34 mm in diameter. The laser energy was individually deployed to the right-sided and left-sided antra of the large CIT with the LB positioned at the ostium of the CIT's right and left branches. The complete electrical isolation of the three PVs was achieved. The patient remained stable without any symptoms or AF recurrence 1 year post ablation.
Discussion:
The LBA, which is individually deployed to the right-sided and left-sided antra of the large CIT with the third-generation LB positioned at the ostium of the right and left branches of the CIT without laser energy deployment to the posterior wall of the CIT, may be one of the effective strategies for patients with large CITs.
Case Report: A prenatal diagnosis of osteogenesis imperfecta in a patient with a novel pathogenic variant in COL1A2
Authors: Melissa Sindy Peláez Chomba, Guillermo Raúl Vásquez Gómez, Yasser Ciro Sullcahuaman Allende, Julio Cesar Mendoza Fernández, Nelson David Purizaca Rosillo, Alejandra Zevallos, Vicente Leandro Cruzate Cabrejos
Journal: F1000Res (2023)
Keywords: osteogenesis imperfecta, newborn, prenatal diagnosis
MeSH terms: Collagen Type I / genetics, Osteogenesis Imperfecta / diagnostic imaging, Osteogenesis Imperfecta / genetics, Case Reports, Adult, Female, Humans, Infant, Newborn, Mutation / genetics, Pregnancy, Prenatal Diagnosis, Collagen Type I, alpha2 Subunit, Collagen Type I, COL1A2 protein, human

Osteogenesis imperfecta is considered a rare genetic condition which is characterized by bone fragility. In 85% of cases, it is caused by mutations in COL1A1 and COL1A2 genes which are essential to produce type I collagen. We report the case of a female neonate delivered to a 27-year-old women at San Bartolomé Teaching Hospital with a family history of clavicle fracture. A prenatal control with ultrasound was performed to the mother at 29 weeks. A fetus with altered morphology and multiple fractures was found. Therefore, a prenatal diagnosis of osteogenesis imperfecta was performed. The neonate was born with a respiratory distress syndrome and an acyanotic congenital heart disease. Therefore, she remained in NICU until her death. We highlight the importance of prenatal diagnosis, genetic counseling and a multidisciplinary evaluation in this type of pathologies and report a new probably pathogenic variant in the COL1A2 gene detected by exomic sequencing in amniotic fluid.
Neurocognitive deficits after botulism: a clinical case series study
Authors: Laura Rosenqvist, Charlotte Sandvei, Sigurdur Skarphedinsson
Journal: Front Neurol (2024)
Keywords: botulism, case series study, cognitive impairment, long-term effects, neuropsychological assessment

Purpose:
This case study examined long-term cognitive deficits after botulism. Only a very limited number of studies on post-acute cognitive impairment after botulism exist, and data are incomplete.
Method:
A semi-structured interview on long-term cognitive consequences of botulism was conducted for six family members, who contracted the infection after ingestion of lumpfish-roe 2.5 years ago. Two of the family members underwent neuropsychological assessment of attention, memory, and executive functioning as well.
Finding:
Results of the semi-structured interviews showed individual subjective cognitive deficits across processing speed, attention, concentration, short-and long-term memory, and executive functioning. Test results showed mild cognitive impairment in attention and mild-moderate deficits in executive functioning.
Conclusion:
These results support previous findings that patients of various infectious diseases may suffer unspecific long-term neurocognitive deficits. Assessment and initiation of relevant post-acute treatment and rehabilitation might be central to prognosis, functional ability, and psychological well-being.
A Case Report of Mycoplasma pneumoniae-induced fulminant myocarditis in a 15-year-old male leading to cardiogenic shock and electrical storm
Authors: Chengrui Zhu, Bo Hu, Xiaotong Li, Weiying Han, Yingjian Liang, Xiaochun Ma
Journal: Front Cardiovasc Med (2024)
Keywords: mycoplasma pneumoniae, cardiogenic shock, case report, myocarditis, ventricular arrhythmia
MeSH terms: Case Reports

Mycoplasma pneumoniae (M. pneumoniae) is a well-recognized pathogen primarily associated with respiratory tract infections. However, in rare instances, it can lead to extrapulmonary manifestations, including myocarditis. We present a case of a 15-year-old male who developed fulminant myocarditis, cardiogenic shock, and cardiac electrical storm attributed to M. pneumoniae infection. He underwent a combination of intra-aortic balloon pump (IABP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiac support, ultimately surviving despite the intracardiac thrombus formation and embolic stroke. Following comprehensive treatment and rehabilitation, he was discharged in stable condition. This case underscores the importance of considering atypical pathogens as potential etiological factors in patients presenting with cardiac complications, especially in the adolescents. It also emphasizes the need for clinical vigilance and effective support for potential cardiac complications arising from M. pneumoniae infection.
Case report: intracranial lesions in a patient with anxiety and depression: tumor recurrence or radiation encephalopathy?
Authors: Haiping You, Lin He, Zhibo Ouyang, Yao Yang, Shu Xie, Jiwei Zhou, Yun Zhang, Jian Shi
Journal: Front Oncol (2024)
Keywords: anxiety disorders, depressive disorders, nasopharyngeal cancer, radiation encephalopathy, radiotherapy
MeSH terms: Case Reports

Purpose:
Radiation encephalopathy (REP) is one of the most common complications of radiotherapy for malignant tumors of the head and neck. Symptoms usually appear months to years following radiotherapy, with headache, insomnia, and memory loss as the main clinical features. We report a patient who was admitted to the hospital with anxiety and depressive disorder and was eventually diagnosed with REP.
Patients and methods:
A 48-year-old patient who had undergone over 2 years of radiotherapy for nasopharyngeal carcinoma was admitted to the Department of Psychosomatic Medicine of our hospital because of recurrent fear, low mood, and waking up from dreams. Magnetic resonance imaging (MRI) revealed a mass in the left temporal lobe with a large peripheral edema. After multidisciplinary consultation, the possibility of tumor recurrence could not be excluded.
Results:
Resection of the lesioned brain tissue to obtain pathological tissue showed glial cell proliferation and small focal areas of degeneration and necrosis, which indicated that the lesions were inflammatory. Postoperative MRI showed no abnormal signal, and the patient's condition improved.
Conclusion:
Nasopharyngeal carcinoma patients with a history of radiotherapy and symptoms of increased intracranial pressure and neurological damage should be examined for REP. Furthermore, patients may experience anxiety and depressive disorders as a result of temporal lobe damage caused by REP.
Disease-modifying therapies and hematological disorders: a systematic review of case reports and case series
Authors: Cristina Scavone, Valerio Liguori, Olusola Jephthah Adungba, Daniele Di Giulio Cesare, Maria Giuseppa Sullo, Vincenzo Andreone, Liberata Sportiello, Giorgia Teresa Maniscalco, Annalisa Capuano
Journal: Front Neurol (2024)
Keywords: dmt, case reports, case series, hematological disorders, multiple scleorsis, systematic reveiw
MeSH terms: Systematic Review

Introduction:
Disease modifying therapies (DMTs) used to treat multiple sclerosis (MS) can be associated to the occurrence of hematological disorders. This systematic review aims to provide an overview of these events occurring in real-life conditions, by describing case reports and series published in the literature.
Methods:
A literature search of all publications up to January 5th 2024 on the Medline and Embase databases was carried out. The results were presented both in the text and in tables.
Results:
Sixty-seven case reports/series were included in this review, of which more than half related to alemtuzumab, natalizumab and ocrelizumab. The publication date of included studies ranged from 2006 to 2024. The majority of case reports and series described the occurrence of late-onset hematological disorders (events that occurred more than 30 days after the first DMT administration), mainly represented by case of neutropenia, autoimmune hemolytic anemia and immune thrombocytopenia. All cases reported a favorable outcome, apart one case report that described a fatal case. Among included cases, 4 articles, all related to natalizumab, described the occurrence of myeloid disorders in 13 newborns from mother receiving the DMT.
Discussion:
Considering the limitations identified in the majority of included studies, further ad hoc studies are strongly needed to better evaluate the hematological disorders of DMTs. Meantime, the strict monitoring of treated patients for the occurrence of these toxicities should be highly recommended.