OpenMed/multicare-articles huggingface dataset:
Refractory Ventricular Tachycardia From Coronary Vasospasm During Pregnancy
Authors: Kevin Ergle, Michael Bernard
Journal: Ochsner J (2019)
Keywords: coronary vasospasm, pregnancy complications–cardiovascular, tachycardia–ventricular
MeSH terms: Case Reports

Background: Coronary vasospasm leading to variant angina is uncommon, and the condition is rare in pregnant patients. Many physiologic changes occur during pregnancy, but how these changes affect the spasticity of coronary arteries in patients predisposed to vasospasm is unknown. Vasospasm causing unstable arrhythmia from multiple foci can be difficult to treat. Case Report: A 22-year-old gravida 1 para 0 female at 17 weeks' gestation with twins presented with chest pain refractory to sublingual nitroglycerin, ST segment elevation on electrocardiogram, and subsequent ventricular tachycardia requiring a shock by her implantable cardioverter defibrillator (ICD). The patient had a history of coronary vasospasm with ventricular arrhythmia that required placement of the ICD 5 years prior. Because of refractory symptoms, she required prolonged admission in the intensive care unit with high-dose intravenous nitroglycerin, calcium channel blockers, benzodiazepines, beta blockers, chemical sympathectomy, and intubation and sedation. Despite these measures, the patient continued to have vasospasm and ventricular tachycardia, so cesarean delivery and tubal ligation were performed. After delivery, she was rapidly weaned from all invasive treatment modalities and was discharged on oral nitrates and calcium channel blockers. Conclusion: To our knowledge, this case is the first report of severe drug-refractory vasospastic angina triggered by pregnancy. The hormonal and nervous system changes that occur during pregnancy appear to be a trigger for vasospasm, further highlighted by the quick resolution of the patient's symptoms postdelivery. A multidisciplinary approach for treatment of both mother and baby was necessary. Our case provides a cautionary tale that patients with refractory vasospastic angina may want to pursue definitive contraception.
Case report: Transfusion independence and abolition of extravascular hemolysis in a PNH patient treated with pegcetacoplan
Authors: Bruno Fattizzo, Francesco Versino, Anna Zaninoni, Anna Paola Maria Luisa Marcello, Cristina Vercellati, Silvia Artuso, Wilma Barcellini
Journal: Front Immunol (2022)
Keywords: direct antiglobulin test, ektacytometry, extravascular hemolysis, paroxysmal nocturnal hemoglobinuria, pegcetacoplan
MeSH terms: Hemoglobinuria, Paroxysmal / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Complement C3, Complement C5, Complement Inactivating Agents / therapeutic use, Hemolysis, Humans, Quality of Life, pegcetacoplan, Complement C3, Complement Inactivating Agents, Complement C5

More than half of patients with paroxysmal nocturnal hemoglobinuria (PNH) treated with complement fraction C5 inhibitors experience residual anemia and hemolysis. This is partly due to the persistent activation of the complement cascade upstream C5, resulting in C3 deposition on PNH erythrocytes and extravascular hemolysis in the reticuloendothelial system. Pegcetacoplan is the first proximal C3 inhibitor to be approved for PNH basing on favorable efficacy and safety data in both naïve and eculizumab treated PNH. Here we report the first Italian patient treated with pegcetacoplan in a named patient program. The patient suffered from hemolytic PNH associated with CALR+ myeloproliferative neoplasm and was heavily transfusion dependent despite eculizumab therapy. Treatment with pegcetacoplan induced a dramatic improvement in Hb, along with normalization of unconjugated bilirubin and reticulocytes, as markers of extravascular hemolysis. Sequential laboratory workup showed the disappearance of C3 deposition on erythrocytes by direct anti-globulin test, the increase of PNH clone on erythrocytes, and a peculiar right shift of the ektacytometry curve. The drug was well tolerated, and the patient reported a significant improvement in his quality of life. Overall, pegcetacoplan appears a safe and effective option "ready to use" in the clinic for patients with PNH and suboptimal response to anti-C5 agents.
Case Report: Embedding "Digital Chronotherapy" Into Medical Devices-A Canine Validation for Controlling Status Epilepticus Through Multi-Scale Rhythmic Brain Stimulation
Authors: Mayela Zamora, Sebastian Meller, Filip Kajin, James J Sermon, Robert Toth, Moaad Benjaber, Derk-Jan Dijk, Rafal Bogacz, Gregory A Worrell, Antonio Valentin, Benoit Duchet, Holger A Volk, Timothy Denison
Journal: Front Neurosci (2021)
Keywords: arnold tongues, centromedian thalamus, chronotherapy, circadian, deep brain stimulation, entrainment, epilepsy, status epilepticus
MeSH terms: Case Reports

Circadian and other physiological rhythms play a key role in both normal homeostasis and disease processes. Such is the case of circadian and infradian seizure patterns observed in epilepsy. However, these rhythms are not fully exploited in the design of active implantable medical devices. In this paper we explore a new implantable stimulator that implements chronotherapy as a feedforward input to supplement both open-loop and closed-loop methods. This integrated algorithm allows for stimulation to be adjusted to the ultradian, circadian and infradian patterns observed in patients through slowly-varying temporal adjustments of stimulation and algorithm sub-components, while also enabling adaption of stimulation based on immediate physiological needs such as a breakthrough seizure or change of posture. Embedded physiological sensors in the stimulator can be used to refine the baseline stimulation circadian pattern as a "digital zeitgeber," i.e., a source of stimulus that entrains or synchronizes the subject's natural rhythms. This algorithmic approach is tested on a canine with severe drug-resistant idiopathic generalized epilepsy exhibiting a characteristic diurnal pattern correlated with sleep-wake cycles. Prior to implantation, the canine's cluster seizures evolved to status epilepticus (SE) and required emergency pharmacological intervention. The cranially-mounted system was fully-implanted bilaterally into the centromedian nucleus of the thalamus. Using combinations of time-based modulation, thalamocortical rhythm-specific tuning of frequency parameters as well as fast-adaptive modes based on activity, the canine experienced no further SE events post-implant as of the time of writing (7 months). Importantly, no significant cluster seizures have been observed either, allowing the reduction of rescue medication. The use of digitally-enabled chronotherapy as a feedforward signal to augment adaptive neurostimulators could prove a useful algorithmic method in conditions where sensitivity to temporal patterns are characteristics of the disease state, providing a novel mechanism for tailoring a more patient-specific therapy approach.
Successful ziprasidone monotherapy in a case of delusional parasitosis: a one-year followup
Authors: Domenico De Berardis, Nicola Serroni, Stefano Marini, Gabriella Rapini, Alessandro Valchera, Michele Fornaro, Monica Mazza, Felice Iasevoli, Giovanni Martinotti, Massimo Di Giannantonio
Journal: Case Rep Psychiatry (2013)

Delusional parasitosis is characterized by the false idea that own body is infested by invisible mites, insects, or other parasites. This case report describes a 24-year-old woman with delusional parasitosis who was treated with ziprasidone monotherapy (120 mg/day) with a complete remission of delusion and followed for one year without symptom recurrences. These findings, although preliminary, indicate that further investigation of ziprasidone monotherapy for the treatment of delusional parasitosis is warranted in further trials.
Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series
Authors: Leah Couzner, Natalie Spence, Karina Fausto, Yan Huo, Lynn Vale, Samantha Elkins, Johanna Saltis, Monica Cations
Journal: Front Rehabil Sci (2022)
Keywords: behavior, dementia, hospitals, inpatient care, mental health, psychological trauma, trauma-informed care

Introduction:
Up to 70% of older adults have experienced a psychologically traumatic event in their life. Traumatic events can have lifelong effects on functioning and emotion regulation and can affect behavior and experiences in care settings. Common healthcare practices and environments can be re-traumatizing for trauma survivors. These features may trigger behavior change (e.g., aggression and agitation) particularly after the onset of dementia. However, very little research exists to understand how the effects of traumatic events manifest in aged care settings. Trauma-informed care is a framework in which the potential impact of trauma is acknowledged, and practices and procedures are adapted to maximize feelings of control and safety for the patient. Trauma-informed care is an innovative approach with little published evidence in acute geriatric settings.
Methods:
We present a series of cases to demonstrate how psychological trauma can affect the experience of inpatient care for older people. The cases detail the patients' relevant background, triggers and behaviors followed by the steps taken by staff to support the patient and respond to their trauma-related needs. These cases describe how the principles of trauma-informed care can be applied to recognize when past psychologically traumatic events are impacting the older adult in hospital. The outcomes of these interventions are reported on in terms of their impact on challenging behavior, patient experiences and satisfaction with care, and/or staff confidence and skill.
Findings:
A range of past events negatively impacted the patients during their time in hospital, including childhood abuse, military service, and domestic violence. Staff implemented strategies to accommodate trauma-related needs while providing care that improved safety and reduced patient distress. Principles of trauma-informed care were applied where able, including providing choices and enabling autonomy. However, organizational and environmental features of inpatient wards continued to pose risks for re-traumatisation.
Conclusions:
Trauma-informed care is an under-utilized yet potentially beneficial approach to care for older adults in the hospital setting. The cases detailed here demonstrated that the impact of psychological trauma requires an individualized response from staff which when effectively implemented can promote staff and patient safety, reduce the risk of re-traumatisation, and minimize adverse events.
Case report: Complete response to pembrolizumab in a liver metastatic colon adenocarcinoma patient with a novel likely pathogenic germline MSH2 mutation
Authors: Yanjie Xu, Qin Li, Jiemin Zhao, Xuefeng Ni, Ping Li, Wenwei Hu
Journal: Front Immunol (2022)
Keywords: lynch syndrome, msh2, pd-1 inhibitors, colorectal cancer, germline mutation
MeSH terms: Adenocarcinoma / drug therapy, Adenocarcinoma / genetics, Colonic Neoplasms / drug therapy, Colonic Neoplasms / genetics, Colorectal Neoplasms, Hereditary Nonpolyposis / drug therapy, Colorectal Neoplasms, Hereditary Nonpolyposis / genetics, Case Reports, Research Support, Non-U.S. Gov't, Adult, Germ Cells, Germ-Line Mutation, Humans, Liver / pathology, Male, MutS Homolog 2 Protein / genetics, Mutation, MutS Homolog 2 Protein, pembrolizumab, MSH2 protein, human

Lynch syndrome (LS) is a genetic disorder mainly caused by germline mutations in mismatched repair (MMR) genes (MSH2, MLH1, MSH6, and PMS2) or deletions of the epithelial cell adhesion molecule gene (EPCAM). A 43-year-old Chinese male patient underwent radical surgery and was pathologically confirmed to have stage IIIB colon adenocarcinoma. After four cycles of standard adjuvant chemotherapy, the tumor reoccurred in situ with intestinal obstruction. The patient received secondary colectomy. Immunohistochemistry analysis revealed a loss of MSH2 protein expression in the surgical specimen. Noticing that the patient's mother and grandfather all were diagnosed with LS-related cancers, we collected the patient's and his mother's peripheral blood for genetic testing, and the result showed a six-base deletion of MSH2. Thus, we concluded that our patient had LS. Subsequently, the patient accepted pembrolizumab as the first-line systemic therapy after liver metastases. He achieved clinical complete response (cCR) within 2 months and remained progression-free for more than 2 years. The case report showed that MSH2 mutation (c.489_494deTGGGTA) is a likely pathogenic mutation, and immunotherapy (pembrolizumab) is effective for this patient.
Two Cases of Spontaneous Recurrent Hemarthrosis of the Shoulder with Acromial Erosion Associated with Impingement Syndrome
Authors: Shoji Fukuta, Katsutoshli Miyatake, Tetsuya Matsuura, Koichi Sairyo
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Spontaneous recurrent hemarthrosis of the shoulder is rare. Most previously reported cases were associated with massive rotator cuff tear and degenerative glenohumeral arthritis. We described two cases of recurrent hemarthrosis without osteoarthritis of the shoulder. Both cases had bony erosion of the acromion, which was confirmed arthroscopically as the origin of bleeding. Arthroscopic coagulation, acromioplasty, and drainage were successful and there was no recurrence of hemorrhage.
Pain Management Associated with Posttraumatic Unilateral Temporomandibular Joint Anterior Disc Displacement: A Case Report and Literature Review
Authors: Arturo Garrocho-Rangel, Andrea Gómez-González, Adriana Torre-Delgadillo, Socorro Ruiz-Rodríguez, Amaury Pozos-Guillén
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

The aim of the present article is to review the etiological risk factors and the general and oral management of anterior disc displacement with reduction caused by a chin trauma, and to describe the diagnostic process and the treatment provided to an affected 7-year-old girl. The patient also experienced frequent and severe cephaleas, which may be related to cervical vertebrae deviation. The patient was successfully treated with an intraoral occlusal splint and analgesics. Pediatric dentists must always be aware of the early signs and symptoms of temporomandibular joint disorders in their patients, especially in cases of orofacial trauma history, with the aim of providing an opportune resolution and preventing its progression later in life. Occlusal splints are strongly recommended for the treatment of anterior disc displacement with reduction in children and adolescents.
Pulmonary MALT lymphoma: A case report and review of the literature
Authors: Lintao Bi, Jun Li, Wang Dan, Zhenxia Lu
Journal: Exp Ther Med (2015)
Keywords: lymphoma, mucosa-associated lymphoid tissue, pulmonary

Mucosa-associated lymphoid tissue (MALT) lymphoma is an extranodal low-grade B-cell lymphoma. Pulmonary MALT lymphoma is considered to originate from bronchial MALT and is also referred to as bronchial-associated lymphoid tissue lymphoma. Pulmonary MALT lymphoma is a rare disease, but it is the most frequent subset of primary pulmonary lymphoma. The median age at diagnosis of pulmonary MALT lymphoma is 50-60 years, with only few patients aged <30 years. This is the case report of a 19-year-old patient with pulmonary MALT lymphoma presenting with a multiple pulmonary consolidation pattern on computed tomography scans, who underwent successful chemotherapeutic treatment with a chlorambucil-based regimen.
Free flap reconstruction of Achilles tendon and overlying skin defect using ALT and TFL fabricated chimeric flap
Authors: Junji Ando, Minoru Sakuraba, Atsushi Sugawara, Aya Goto, Shuchi Azuma, Nobuyuki Mitsuhashi, Kousuke Sasaki, Itaru Sone
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: achilles tendon, chimeric free flap, anterolateral thigh flap, reconstruction, tensor fascia latae flap
MeSH terms: Case Reports

A 33-year-old man developed a left Achilles tendon rupture and skin necrosis. We reconstructed the defect using an anterolateral thigh flap and a tensor fasciae lata muscle flap in a chimeric fashion. he was able to stand on a toe of the operated foot without help 6 months postoperatively.
Giant Anterior Chest Wall Basal Cell Carcinoma: An Approach to Palliative Reconstruction
Authors: Pauline Joy F Santos, Christina Prendergast, Amber Leis
Journal: Case Rep Oncol Med (2016)

Anterior chest wall giant basal cell carcinoma (GBCC) is a rare skin malignancy that requires a multidisciplinary treatment approach. This case report demonstrates the challenges of anterior chest wall GBCC reconstruction for the purpose of palliative therapy in a 72-year-old female. Surgical resection of the lesion included the manubrium and upper four ribs. The defect was closed with bilateral pectoral advancement flaps, FlexHD, and pedicled VRAM. The palliative nature of this case made hybrid reconstruction more appropriate than rigid sternal reconstruction. In advanced metastatic cancers, the ultimate goals should be to avoid risk for infection and provide adequate coverage for the defect.
Case Report: Good Prognosis of Mixed Alien Hand Syndrome by Verbal-Cue Rehabilitation Exercise
Authors: Kang Qu, Lin Gan, Wei Jiang, Peng Yu, Ming Dong
Journal: Front Neurol (2021)
Keywords: alien hand syndrome, case report, cerebral infarction, corpus callosum, prognosis
MeSH terms: Case Reports

Mixed alien hand syndrome is a rare disease reported in the literature. The mixed callosal-frontal variant of alien hand syndrome is associated with uncoordinated hand movements, and patients may present with an involuntary grasp reflex and intermanual conflict. There are few videos in the existing literature on the comparison of patients' condition before and after recovery of the symptoms of mixed alien hand syndrome. We presented the prognosis of mixed alien hand syndrome in the form of a video. In addition, we have included some videos on the comparison of the condition of patients before and after recovery of the symptoms of mixed alien hand syndrome. A 57-year-old woman presented with left-handed intermanual conflict and right-handed involuntary grasp reflex due to infarction of the frontal lobe and corpus callosum. She was diagnosed with a mixed callosal-frontal variant of alien hand syndrome. Her left hand counteracted the purposeful movements of the right hand. However, the intermanual conflict disappeared after 3 months of therapy, including drug treatment and verbal-cue rehabilitation, and she regained normal coordination of her hand movements. Her prognosis was good despite the large corpus callosum lesions. The uncoordinated hand movements of the patient affected her daily life and caused psychological problems. Initiating rehabilitation early was important and necessary for her to regain coordination. It is possible that the verbal-cue training method played an important role in the recovery of the patient. Therefore, this method of rehabilitation deserves consideration and can be adopted in larger cohort studies as we presented only a single case. The possible mechanisms behind the verbal-cue exercise require further studies, and this patient had a good prognosis despite severe corpus callosum injury, which may merit further investigation.
Juvenile Nasopharyngeal Angiofibroma: A Case Report of a Rare Adolescent Head and Neck Tumor
Authors: Sai Santhosha Mrudula Alla, Deekshitha Alla, Vysakh Ratheesh, Pavan Kumar Ramineni, Ajay Singh, Vaishnavi K, Ayesha Siddiqua
Journal: Cureus (2023)
Keywords: androgens, computed tomography, flutamide, juvenile nasopharyngeal angiofibroma, surgical resection
MeSH terms: Case Reports

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign head and neck tumor. We report a rare case of JNA, provide a brief literature review, and treatment options, and emphasized the role of flutamide as pre-surgical medication for tumor regression. JNA primarily affects adolescent males aged 14 to 25 years. There are various theories explaining the formation of the tumor. However, sex hormones are found to play a crucial role in the etiology of the tumor. In recent years testosterone and dihydrotestosterone receptors have been identified on the tumor thus suggesting the strong influence of hormones. This permits the use of flutamide, an androgen receptor blocker, as adjuvant therapy for the treatment of JNA. This is a case of a 12-year-old boy who presented to the hospital with right-sided nasal obstruction, epistaxis, watery nasal discharge, and a mass in the right nasal cavity for two months. Diagnostic nasal endoscopy, ultrasonography, computed tomography, and magnetic resonance imaging were done. These investigations confirmed the diagnosis of JNA stage IV. The patient was started on treatment with flutamide for tumor regression.
Pulmonary Artery Catheter Seemingly Entrapped in the Skull
Authors: S M Friedman, G R Rajan
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

A pulmonary artery catheter is an important tool for the monitoring of hemodynamics in patients. Unfortunately, misplacement of a catheter tip may occur in the vasculature local to the intended placement. Misplacement of the catheter can be further complicated by entrapment at the unintended destination. We present a case of a misplaced and entrapped pulmonary artery catheter in a patient with worsening pulmonary disease. After multiple unsuccessful attempts to float the catheter, it was partially retracted and found to be stuck. Imaging showed the tip terminating in the right internal jugular vein at the level of the jugular foramen. It was initially suspected that the catheter had become looped, knotted, or otherwise entangled within the vasculature of the skull and surgical removal would be necessary. Before surgical removal was performed, it was instead determined that the catheter had become kinked and entrapped at the end of the introducer sheath, and noninvasive removal was accomplished by first removing the introducer sheath.
Stress-Relieving Video Game and Its Effects: A POMS Case Study
Authors: Abdullah Ajmal, Hamza Aldabbas, Rashid Amin, Sundas Ibrar, Bader Alouffi, Mehdi Gheisari
Journal: Comput Intell Neurosci (2022)
MeSH terms: Video Games, Retracted Publication, Culture, Emotions, Humans, Muscles, Upper Extremity

Stress is the response or a change in our bodies to environmental factors like challenges or demands that are physical and emotional. The main cause of stress is illnesses and it is gaining more interest, a hot topic for many researchers. Stress can be brought about by a wide range of normal life occasions that are hard to avoid. Stress generally refers to two things: first, the psychological perception of pressure and the body's response to it. On the other hand, it involves multiple systems, from metabolism to muscles to memory. Many methods and tools are being developed to reduce stress in humans. Stress can be a short-term issue or a long-term problem, depending on what changes in your life. The emphasis of this article is to reduce the effects of stress by developing a stress-releasing game and verifying its results through the Profile of Mood States (POMS) and POMS-2 survey. Games are associated with stress levels; hence, parameters like sounds, visuals, and colors associated with reducing stress are used to develop a game for the stress reduction in the players. The survey research aims to determine that the purpose-built game will affect the player's stress level using a reliable psychological survey paper. The survey collected a variety of information from its participants over six months. Different aspects of a person's psychology and reactions are recorded in this scenario by calculating the mean, standard deviation, degree of freedom, zero-error, and probability-value%. The POMS and POMS-2 results are obtained from the custom-built game, and these are found to be effective in reducing stress.