OpenMed/multicare-articles huggingface dataset:
Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child
Authors: Nathalie Nasr, Louis Delamarre, Emmanuel Cheuret, Gerald Chausseray, Jean Marc Olivot, Philippe Acar, Fabrice Bonneville
Journal: Front Neurol (2021)
Keywords: acute stroke, child, congenital heart disease, ischemic stroke, thrombectomy
MeSH terms: Case Reports

Despite extensive evidence of benefit of thrombectomy in adult ischemic stroke due to large-vessel occlusion in the 6-h window, its role remains uncertain in very young children. We describe hereafter the case of a 2-year-old female child who had a successful thrombectomy 9 h after stroke onset. The patient presented with right hemiplegia, central facial palsy, a normal level of consciousness, and speech difficulties. The PedNIHS score was 11. CT scan without contrast injection displayed spontaneous hyperdensity of the middle cerebral artery (MCA), with only limited early signs of ischemia (ASPECTS 8). CT angiography demonstrated occlusion of the proximal MCA with good collaterals. Thrombectomy was realized. Complete recanalization (TICI 3) was obtained under general anesthesia after two passes of a stent retriever. Time from symptoms onset to full recanalization was 9 h. The acute ischemic stroke was caused by embolic thrombus from a congenital heart disease. Clinical recovery was complete. Three months after the thrombectomy, the young patient was doing well without any neurological sequelae (PedNIHSS 0; modified Rankin Scale: 0). This case report is an example of a decision-making process to perform thrombectomy in a very young child, which included cardio-embolic etiology as a parameter that potentially might have participated to the successful outcome of the therapeutic procedure.
Coexistence of congenital diaphragmatic hernia and abdominal wall closure defect with chromosomal abnormality: two case reports
Authors: Seiichiro Inoue, Akio Odaka, Yuki Muta, Yoshifumi Beck, Hisanori Sobajima, Masanori Tamura
Journal: J Med Case Rep (2016)
MeSH terms: Abdominal Wall / abnormalities, Chromosome Aberrations, Down Syndrome / diagnosis, Heart Defects, Congenital / complications, Hernia, Umbilical / diagnostic imaging, Hernias, Diaphragmatic, Congenital / complications, Case Reports, Fatal Outcome, Heart Defects, Congenital / pathology, Heart Defects, Congenital / therapy, Heart Failure / etiology, Hernia, Umbilical / complications, Hernias, Diaphragmatic, Congenital / pathology, Hernias, Diaphragmatic, Congenital / therapy, Humans, Infant, Newborn, Karyotyping, Male, Ultrasonography, Prenatal

Background:
We reported two rare cases of congenital diaphragmatic hernia with abdominal wall closure defect, which were not associated with septum transversum diaphragmatic defects or Fryns syndrome.
Case presentation:
Case 1: a Japanese baby boy was delivered at 37 weeks' gestation by urgent cesarean section because of the diagnosis of severe fetal distress. Congenital diaphragmatic hernia with omphalocele was prenatally diagnosed with fetal ultrasound. A ruptured omphalocele was confirmed at delivery. A silo was established on the day of his birth; direct closure of his diaphragmatic defect and abdominal wall closure was performed on the fifth day after his birth. Trisomy 13 was confirmed by genetic examination. His postoperative course was uneventful and he was discharged 5 months postnatally with home oxygen therapy. He was readmitted because of heart failure and died at 6 months. Case 2: a Japanese baby boy, who was prenatally diagnosed with gastroschisis, was delivered at 35 weeks' gestation by urgent cesarean section because of the diagnosis of fetal distress. Silo construction using a wound retractor was performed on the day of his birth and direct abdominal closure was performed on the tenth day after his birth. Trisomy 21 was confirmed by genetic examination. Treatment for his respiratory distress was continued after surgery. A retrosternal hernia was revealed at 6 months and direct closure of retrosternal diaphragm with the resection of hernia sac was performed. His postoperative course was uneventful and he was discharged with home oxygen therapy.
Conclusions:
Attention should be paid to chromosomal abnormality in cases in which the coexistence of congenital diaphragmatic hernia and abdominal wall closure defect are observed.
Case Report: A Severe and Multi-Site Nocardia farcinica Infection Rapidly and Precisely Identified by Metagenomic Next-Generation Sequencing
Authors: Mengfan Jiao, Xiang Deng, Hongfu Yang, Junqiang Dong, Jun Lv, Fang Li
Journal: Front Med (Lausanne) (2021)
Keywords: nocardia, case report, infectious disease, metagenomics next-generation sequencing, precise treatment
MeSH terms: Case Reports

Nocardia genus is an aerobic, gram-positive, and opportunistic pathogen, which mainly affects cell-mediated immunosuppressed patients. Early diagnosis and treatment greatly improve prognosis. However, the limitation of golden standard-bacterial culture exists. Here, we report a 61-year-old male with pneumonia, sepsis and intermuscular abscesses induced by Nocardia farcinica. Venous blood culture reported negative results. Former improper diagnosis and treatment did not improve his condition. With the assistant of metagenomic next-generation sequencing, the pathogen was identified as Nocardia farcinica. He was then applied with accurate treatment and had a remarkable clinical and radiological improvement.
Lemierre Syndrome
Authors: Axel Boyer, Laurent Médart, Laurent Collignon
Journal: J Belg Soc Radiol (2022)
Keywords: jugular thrombophlebitis, septic pulmonary emboli
MeSH terms: Case Reports

Teaching Point: Lemierre syndrome is a rare complication of bacterial pharyngitis with cervical thrombophlebitis leading to pulmonary abcesses; the radiologist may have a key role.
Right Testicular Artery Occlusion and Acute Appendicitis by Angiostrongylus costaricensis
Authors: Luis Enrique Sánchez-Sierra, Roberto Antonio Martínez-Quiroz, Héctor S Antúnez, Humberto Cabrera-Interiano, Fernando Josué Barrientos-Melara
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Introduction. Angiostrongylus costaricensis is a nematode from the superfamily Metastrongyloidea, whose etymology is "roundworm that lives in blood vessels". This parasite can be found from the southern United States to northern Argentina and southern Brazil. In 1983, Morera and Ruiz published the first case of a testicular artery occlusion by A. costaricensis. Case Presentation. A five year old boy presented with eight days of pain, denying trauma backgrounds and followed with an increase of volume. The treatment was a right simply orchiectomy, finding necrosis of the testicle, the biopsy showed reddish-purple aspect and soft consistency. Histologic studies reveled the presence of a worm inside the testicular artery. Conclusion. The diagnosis of A. costaricensis infection should be considered in all pediatric patients, with signs and symptoms of orchitis or acute abdomen, from endemic areas, may cause occlusion of the testicular artery and appendicular artery causing testicular and cecal appendix necrosis, respectively, even putting the patient's life at risk. The diagnosis is complex, because the clinical manifestations are similar to an orchitis or acute abdomen, therefore, the definitive diagnosis is made during the surgical intervention and histopathological study.
Turning the trolley with reflective equilibrium
Authors: Tanja Rechnitzer
Journal: Synthese (2022)
Keywords: methodology of ethics, philosophical methods, reconstruction, reflective equilibrium, trolley problem

Reflective equilibrium (RE)-the idea that we have to justify our judgments and principles through a process of mutual adjustment-is taken to be a central method in philosophy. Nonetheless, conceptions of RE often stay sketchy, and there is a striking lack of explicit and traceable applications of it. This paper presents an explicit case study for the application of an elaborate RE conception. RE is used to reconstruct the arguments from Thomson's paper "Turning the Trolley" for why a bystander must not divert a runaway trolley from five workmen onto one. Analyzing Thomson's resulting position with the RE-criteria has two main results: Firstly, the adjustment of one of her commitments can be defended. Secondly, no justified position in RE was reached. With respect to RE as a method, the main results from this application are: (1) There is at least one conception of RE that is sufficiently specified to be applicable; (2) the RE criteria put real constraints on the process of justification; and (3) an explicit application of RE has benefits in terms of clarity while at the same time providing guidance for how the justificatory process could be continued.
Sinonasal adenoid cystic carcinoma following formaldehyde exposure in the operating theatre
Authors: Anniken Sandvik, Tor Audun Klingen, Sverre Langård
Journal: J Occup Med Toxicol (2014)
Keywords: adenoid cystic carcinoma, formaldehyde, nurse, operating theatre, sinonasal cancer, work-related cancer

We present a case report of an auxiliary nurse who developed an adenoid cystic carcinoma in her left maxillary sinus following occupational exposure to formaldehyde in the operating theatre. Currently, the epidemiological evidence that formaldehyde can cause cancer in humans is considered to be limited. Previous case-control-studies of formaldehyde and sinonasal cancer have mainly investigated subjects who were concomitantly exposed to wood dust, a known risk factor to the development of sinonasal adenocarcinoma of intestinal type. Our case report presents a patient who has developed an adenoid cystic carcinoma following exposure to formaldehyde. We suggest that the occupational physician remains alert to formaldehyde as an occupational hazard among health care workers.
Domino Liver Transplantation from a Child with Propionic Acidemia to a Child with Idiopathic Fulminant Hepatic Failure
Authors: Marina Moguilevitch, Ellise Delphin
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Domino liver transplant has emerged as a viable strategy to increase the number of grafts available for transplantation. In the domino transplant organs explanted from one patient are transplanted into another patient. The first successful domino liver transplant was performed in Portugal in 1995. Since then this innovative concept has been applied to several genetic or biochemical disorders that are treated by liver transplantation. An important consideration during this operation is that such livers can pose a risk of the de novo development of the disease in the recipient. That is why this surgical procedure requires careful planning, proper selection of the patients, and informed consent of both donor and recipient.
Clinical, Serological, and Molecular Observations from a Case Series Study during the Asian Lineage Zika Virus Outbreak in Grenada during 2016
Authors: Marco Brenciaglia, Trevor P Noël, Paul J Fields, Satesh Bidaisee, Todd E Myers, William M Nelson, Neeraja Venkateswaran, Kodumudi Venkateswaran, Nishanth Parameswaran, Avi Bahadoor, Katherine Yearwood, Veronica Mapp-Alexander, George Mitchell, A Desiree LaBeaud, Calum N L Macpherson
Journal: Can J Infect Dis Med Microbiol (2018)

This paper describes the spatial and temporal distribution of cases, demographic characteristics of patients, and clinical manifestations of Zika virus (ZIKV) during the 2016 outbreak in Grenada. The first reported case was recorded in St. Andrew Parish in April, and the last reported case was seen in November, with peak transmission occurring in the last week of June, based on test results. Data were collected from a total of 514 patients, of whom 207 (40%) tested positive for ZIKV. No evidence was found that testing positive for ZIKV infection was related to age, gender, or pregnancy status. Clinical presentation with rash (OR = 2.4, 95% CI = 1.5 to 3.7) or with lymphadenopathy (OR = 1.7, 95% CI = 1.0 to 2.9) were the only reported symptoms consistent with testing positive for ZIKV infection. During the Zika outbreak, the infection rate was 20 clinical cases per 10,000 in the population compared to 41 cases per 10,000 during the chikungunya outbreak in Grenada in 2014 and 17 cases per 10,000 during the dengue outbreak in 2001-2002. Even though the country has employed vector control programs, with no apparent decrease in infection rates, it appears that new abatement approaches are needed to minimize morbidity in future arbovirus outbreaks.
Skeletal Muscle Metastasis of a GIST: A Case Report and Review of the Literature
Authors: Olga D Savvidou, George D Chloros, Georgios D Agrogiannis, Penelope Korkolopoulou, Georgios N Panagopoulos, Panayiotis J Papagelopoulos
Journal: Case Rep Surg (2016)
MeSH terms: Case Reports

Gastrointestinal stromal tumors (GISTs) are the most common malignant mesenchymal tumors of the gastrointestinal tract. The most common sites of metastasis are the liver and the peritoneum, whereas metastasis to soft tissue is rare. The authors present the case of a 78-year-old male with a soft tissue metastasis of a GIST and the current literature is reviewed.
Intestinal intussusception related to colonic pedunculated lipoma: A case report and review of the literature
Authors: Johanna Cordeiro, Leonardo Cordeiro, Paula Pôssa, Paula Candido, Alice Oliveira
Journal: Int J Surg Case Rep (2019)
Keywords: abdominal pain, case report, colon, intussusception, lipoma, multidetector computed tomography

Introduction:
Intestinal intussusception is a relatively common cause of bowel obstruction in children, however, it is a rare clinical entity in adults. When seen in adults, it is often caused by some underlying condition, usually of malignant origin. We present a case of intestinal intussusception caused by a benign and rare condition in the gastrointestinal tract.
Case presentation:
A 69-year-old male patient presented with diffuse abdominal pain for 2 months, which intensified in the last two days, associated with diarrhea, vomiting and weight loss, in addition to sporadic episodes of hematochezia. Colonoscopy revealed a vegetative-infiltrative lesion, occupying about 75% of the lumen of the colon, located in the hepatic angle, presumably neoplastic. A biopsy was performed, which revealed mild nonspecific chronic inflammation in activity, in fragments of colonic mucosa. CT scan demonstrated colo-colonic intussusception, associated to an oval formation presenting fat density, suggesting lipoma. The patient underwent laparotomy with intussusception reduction and right partial colectomy. The inspection of the specimen showed a yellowish, pedunculated lesion. Histopathology confirmed a 5.0 cm submucosal lipoma.
Discussion:
Intestinal intussusception is relatively frequent in children and is a rare clinical condition in adults at a ratio of 20:1.4. Sixty to sixty-five percent of the cases of intussusception in the large intestine have malignant etiology. Thus, lipoma as the main cause of colo-colonic intussusception in adults is an uncommon cause.
Conclusion:
Although rare, colonic lipoma should be considered as a differential diagnosis among the causes of large intestinal intussusception in adults.
Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious States
Authors: Julian O'Kelly, L James, R Palaniappan, J Taborin, J Fachner, W L Magee
Journal: Front Hum Neurosci (2013)
Keywords: eeg, assessment, brain injury, diagnosis, disorders of consciousness, minimally conscious state, music therapy, vegetative state

Assessment of awareness for those with disorders of consciousness is a challenging undertaking, due to the complex presentation of the population. Debate surrounds whether behavioral assessments provide greatest accuracy in diagnosis compared to neuro-imaging methods, and despite developments in both, misdiagnosis rates remain high. Music therapy may be effective in the assessment and rehabilitation with this population due to effects of musical stimuli on arousal, attention, and emotion, irrespective of verbal or motor deficits. However, an evidence base is lacking as to which procedures are most effective. To address this, a neurophysiological and behavioral study was undertaken comparing electroencephalogram (EEG), heart rate variability, respiration, and behavioral responses of 20 healthy subjects with 21 individuals in vegetative or minimally conscious states (VS or MCS). Subjects were presented with live preferred music and improvised music entrained to respiration (procedures typically used in music therapy), recordings of disliked music, white noise, and silence. ANOVA tests indicated a range of significant responses (p ≤ 0.05) across healthy subjects corresponding to arousal and attention in response to preferred music including concurrent increases in respiration rate with globally enhanced EEG power spectra responses (p = 0.05-0.0001) across frequency bandwidths. Whilst physiological responses were heterogeneous across patient cohorts, significant post hoc EEG amplitude increases for stimuli associated with preferred music were found for frontal midline theta in six VS and four MCS subjects, and frontal alpha in three VS and four MCS subjects (p = 0.05-0.0001). Furthermore, behavioral data showed a significantly increased blink rate for preferred music (p = 0.029) within the VS cohort. Two VS cases are presented with concurrent changes (p ≤ 0.05) across measures indicative of discriminatory responses to both music therapy procedures. A third MCS case study is presented highlighting how more sensitive selective attention may distinguish MCS from VS. The findings suggest that further investigation is warranted to explore the use of music therapy for prognostic indicators, and its potential to support neuroplasticity in rehabilitation programs.
Synchronous gastric gastrointestinal stromal tumor and colon adenocarcinoma: a case report
Authors: Thivi Vasilakaki, Kalliroi Koulia, Aikaterini Tsavari, Elissavet Arkoumani, Efstratios Kouroumpas, Anargiros Pavlis, Georgios Christopoulos, Konstantinos Stamatiou, Kassiani Manoloudaki, Dimitrios Zisis
Journal: Case Rep Oncol Med (2014)

Gastrointestinal stromal tumors (GISTs) represent the majority of primary mesenchymal tumors of the gastrointestinal tract. They are generally considered to be solitary tumors and therefore the synchronous occurrence with other primary malignancies of gastrointestinal track is considered a rare event. Here we present the case of a 75-year-old man admitted to our hospital with a 10-day history of gastrointestinal bleeding. Colonoscopy revealed an ulcerative mass of 4 cm in diameter in the ascending colon. Gastroscopy revealed a bulge in the gastric body measuring 1 cm in diameter with normal overlying mucosa. Surgical intervention was suggested and ileohemicolectomy with regional lymph node resection along with gastric wedge resection was performed. Pathologic examination of the ascending colon mass showed an invasive moderately differentiated adenocarcinoma stage III B (T3N1M0). Grossly resected wedge of stomach showed a well circumscribed intramural tumor which microscopically was consistent with essentially benign gastrointestinal stromal tumor (according to Miettinen criteria). The patient did not receive additional treatment. Two years later the patient showed no evidence of recurrence or metastasis.
Case Report: Mutations in JAK3 causing severe combined immunodeficiency complicated by disseminated Bacille Calmette-Guérin disease and Pneumocystis pneumonia
Authors: Ying Pan, Hui Pan, Chunan Lian, Beiyan Wu, Jieying Lin, Guang Huang, Binglin Cui
Journal: Front Immunol (2022)
Keywords: jak3 deficiency, mycobacterium tuberculosis, pneumocystis jirovecii, case report, severe combined immunodeficiency
MeSH terms: Pneumonia, Pneumocystis / diagnosis, Pneumonia, Pneumocystis / drug therapy, Severe Combined Immunodeficiency / complications, Severe Combined Immunodeficiency / diagnosis, Severe Combined Immunodeficiency / genetics, Case Reports, Research Support, Non-U.S. Gov't, BCG Vaccine / adverse effects, Female, Humans, Infant, Janus Kinase 3, Mutation, Vaccines, Attenuated / adverse effects, BCG Vaccine, JAK3 protein, human, Janus Kinase 3, Vaccines, Attenuated

Background:
As a form of severe combined immunodeficiency (SCID), Janus kinase 3 (JAK3) deficiency can be fatal during severe infections in children, especially after inoculation of live-attenuated vaccines. We report a unique case of JAK3 deficiency with two compound heterozygous JAK3 mutations complicated by disseminated Bacille Calmette-Guérin (BCG) disease and Pneumocystis pneumonia.
Case description:
A 5-month-old Chinese girl presented with recurring fever and productive cough after BCG vaccination and ineffective antibiotic treatment. Chest CT demonstrated bilateral infiltrations, enlarged mediastinal and axillary lymph nodes, and hypoplasia of the thymus. Mycobacterium tuberculosis and Pneumocystis jirovecii were detected from blood samples by sequencing. Acid-fast bacilli were also found from the sputum aspirate and gastric aspirate. Lymphocyte subset analyses indicated T-B+NK- immunodeficiency, and gene sequencing identified two heterozygous missense mutations (one unreported globally) in the Janus homology 7 (JH7) domain of JAK3. The patient received rifampicin, isoniazid, ethambutol, and trimethoprim/sulfamethoxazole and was discharged after improvements but against advice.
Outcome:
The patient died at 13 months of age due to severe infections and hepatic damage.
Discussion:
SCID should be recognized before inoculation of live-attenuated vaccines in children. Newborn screening for SCID is advocated. Further investigations are needed to better understand the pathogenicity of the variants and molecular mechanism of the JH7 domain of JAK3.
Multiple stab wounds on the left side of the chest in a patient with Situs Inversus Totalis: A lifesaving coincidence
Authors: Ismael Escobar Capriata, Caique Martins Pereira Ternes, João Vítor Ternes Rech, Franciele Kuhn Mesacasa, Robson Amaral, Orli Franzon
Journal: Int J Surg Case Rep (2020)
Keywords: cardiology, emergency, situs inversus totalis, stab wound, trauma
MeSH terms: Case Reports

Introduction:
Situs Inversus Totalis (SIT) is a rare finding of complete reversal of the thoracic and abdominal organs with an estimated incidence of 0.005%-0.01% in the population. Severe trauma has not been reported in this population. We present a case of multiple chest stab wounds in a patient with previously unknown SIT.
Presentation of case:
A 39-year-old male was admitted to the emergency room with multiple stab wounds on the left side of the chest. Upon admission the patient was hypotensive, with miosis and intubated. Significant ECG findings were an inverted P wave, inverted QRS complex and inverted T wave in V1. A chest CT scan showed SIT, hemopneumothorax on the left side and, despite multiple stab wounds on the left side of the chest, no cardiac damage. The surgical team decided for a conservative approach and the patient remained in the ICU for two days. After five days he was discharged in good clinical conditions.
Discussion:
SIT generally does not have a clinical relevance throughout the patients life and most diagnoses are coincidental. However, when discovered in acute surgical cases, it requires an accurate evaluation by the surgical team due to anatomical differences that may produce undesirable outcomes in emergency cases such as appendicitis and general trauma.
Conclusion:
There have been very few reports of SIT and trauma in the medical literature. This might be the first ever reported case of a patient with SIT who suffered multiple stab wounds on the left side of the chest and was saved because of his condition.