OpenMed/multicare-articles huggingface dataset:
Endovascular Treatment of Intracerebral Giant Cell Arteritis
Authors: Claus Z Simonsen, Lasse Speiser, Ib Tønder Hansen, David Jayne, Paul von Weitzel-Mudersbach
Journal: Front Neurol (2020)
Keywords: endovascular therapy, giant cell arteritis, immunosuppression, stroke, vasculitis
MeSH terms: Case Reports

Background: Giant cell arteritis (GCA) is the most common primary systemic vasculitis predominantly affecting large and medium sized vessels. In rare cases, the vasculitis can affect the vessels of the brain. Results: We describe four cases of GCA with involvement of the cerebral vessels causing stroke. These cases were unresponsive to aggressive immunosuppression and we opted to treat with endovascular balloon dilatation of the stenotic areas. The procedure was safe. The four patients were treated in nine sessions and a total of 16 vessels were treated. We observed two dissections with no clinical influence on the patients. Discussion: In patients with stroke due to progressive GCA that is non-responsive to immunosuppression, endovascular therapy is feasible.
Iodine overload and severe hypothyroidism in two neonates
Authors: Selim Kurtoğlu, Leyla Akın, Mustafa Ali Akın, Dilek Çoban
Journal: J Clin Res Pediatr Endocrinol (2009)
Keywords: iodine overload, neonate, hypothyroidism
MeSH terms: Hypothyroidism / chemically induced, Iodine / poisoning, Case Reports, Female, Humans, Infant, Newborn, Male, Maternal Exposure / adverse effects, Milk, Human / chemistry, Iodine

Iodine overload frequently leads to transient hyperthyrotropinemia or hypothyroidism, and rarely to hyperthyroidism in neonates. Iodine exposure can be prenatal, perinatal or postnatal. Herein we report two newborn infants who developed severe hypothyroidism due to iodine overload. The overloading was caused by excessive use of an iodinated antiseptic for umbilical care in the first case, and as a result of maternal exposure and through breast milk with a high iodine level in the second case. Presenting the two cases, we wanted to draw attention to these preventable causes of hypothyroidism in infants.
Don't be scared: insert a mesh!
Authors: Alain Chichom Mefire, Marc Leroy Guifo
Journal: Pan Afr Med J (2011)
Keywords: cameroon, mesh, abdomen, hernia, surgery
MeSH terms: Prosthesis-Related Infections / therapy, Surgical Mesh / adverse effects, Surgical Wound Infection / therapy, Case Reports, Review, Female, Hernia, Ventral / surgery, Humans, Middle Aged, Prosthesis-Related Infections / etiology, Surgical Wound Infection / etiology

Mesh repair is now the gold standard technique of repair on incisional hernias. Infection of the mesh is a challenging complication of this type of repair. The risk of mesh infection has been shown to be greater in case of complicated hernia. We present the case of a 64 years old female who presented with an incarcerated incisional hernia with bowel infarction. Treated with a non absorbable mesh repair, she developed mesh infection. The infection was successively treated with simple drainage. This case and review of relevant literature seem to be an indication that mesh repair could still be considered in cases of complicated hernia. Simple drainage usually helps manage the cases of mesh infection.
Traumatic lumbar spondylolisthesis
Authors: Shujie Tang
Journal: Pak J Med Sci (2013)
Keywords: decompression, fixation, posterior lumbar interbody fusion, reduction, traumatic lumbar spondylolisthesis
MeSH terms: Case Reports

Traumatic lumbar spondylolisthesis is a rare lesion and frequently noted in patients with multiple traumatic injuries. We report one case of L5 traumatic spondylolisthesis, which obtained successful decompression, reduction, interbody fusion and fixation by posterior lumbar interbody fusion, and got satisfactory outcome. We recommend early decompression, reduction, interbody fusion and fixation with posterior instrumentation to obtain the recovery of neurological function and stability of the spine.
Thyroid Cartilage Window Approach to Extract a Foreign Body after Migration into the Paraglottic Space
Authors: Sheikha Alkhudher, Faisal AlObaid, Shabreez Shafi
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice for approximately one week. The diagnosis was made after careful history taking and confirmed by the use of computed tomography scan as the fish bone was not visible endoscopically under local and general anaesthesia. The patient underwent thyroid cartilage window approach, and the fish bone was retrieved. His symptoms have improved significantly, and he did not require tracheostomy. Other cases reported the removal of foreign bodies by other techniques such as laryngofissure and posterolateral approach. Our case is different in that we used a modification of thyroplasty type 1 technique as it has less reported complications than other approaches that were published in literature.
VO 2 Max Improvement of 96% in a Non-Elite Recreational Athlete over 24 Months
Authors: Daniel Laury, Armin Tehrany
Journal: Surg J (N Y) (2019)
Keywords: vo 2 max, aerobic exercise, cardiopulmonary stress test, exercise induced asthma
MeSH terms: Case Reports

VO 2 max is a measure of athletic performance and is generally considered an excellent health parameter for athletic performance testing. Various methods are used to generate such a result generally using a treadmill or cycle ergometer. Improvements have been shown through training. The upper limit of such improvement has been difficult to find in the literature in part because testing often starts with individuals already at a superior level of performance. As genetics may play a significant role in an individual's VO 2 max, training can only contribute a portion of the result. Humans have a range of maximal oxygen utilization with upper limits approaching 100 mL/kg. This case report demonstrates a 96% improvement over time secondary to selective intense training. The intent was to document objectively amelioration of the VO 2 max using a defined protocol on standardized testing equipment. This may lead to more efficient training of individuals desiring performance improvement.
Jejunal Intussusception: A Rare Adult Presentation of Lymphoid Hyperplasia
Authors: Linda Laham, Ratul Bhattacharyya, Manrique Guerrero, Jafar Haghshenas, Mark Ingram
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

A 21-year-old African-American male presented to the emergency room with a sudden diffuse onset abdominal pain of one day duration. CT findings revealed mild telescoping of loops of small bowel and mesenteric fat in the left mid abdomen with no apparent masses. The patient underwent an exploratory laparoscopy revealing intussusception of the mid jejunum. As a fair amount of distention compromised safe navigation of the bowel, laparoscopic resection was not warranted at this time. Open approach allowed for segmental resection of the affected segment of the small bowel. This was followed by primary anastomosis. Pathological findings revealed focal reactive lymphoid hyperplasia with marked congestion in the lamina propria of the jejunum. The patient had an unremarkable postoperative period and recovered with no further complications.
Case report: Transient lactate elevation by intravenous insulin infusion therapy for diabetic ketoacidosis in a patient with mitochondrial DNA 3243 A > G mutation: A glycolysis rebooting syndrome?
Authors: Wataru Ohwada, Hidemichi Kouzu, Tatsuya Sato, Kahomi Sazawa, Azumi Matsui, Nobutaka Nagano, Masayuki Koyama, Noriko Ogasawara, Akifumi Takada, Toshiyuki Yano, Masato Furuhashi
Journal: Front Cardiovasc Med (2023)
Keywords: cardiomyopathy, case report, diabetic ketoacidosis, glycolysis, lactate metabolism, mitochondrial disease
MeSH terms: Case Reports

Mitochondrial disease, most cases of which are caused by mitochondrial DNA (mtDNA) mutation, is present with multiple phenotypes including diabetes mellitus, sensorineural hearing loss, cardiomyopathy, muscle weakness, renal dysfunction, and encephalopathy, depending on the degree of heteroplasmy. While mitochondria play an important role in intracellular glucose and lactate metabolism in insulin-sensitive tissues such as muscles, appropriate strategies for glycemic control have not yet been established in a patient with mitochondrial disease, which is often complicated by myopathy. Here, we describe the history of a 40-year-old man with mtDNA 3243A > G who had sensorineural hearing loss, cardiomyopathy, muscle wasting, and diabetes mellitus with stage 3 chronic kidney disease. He developed mild diabetic ketoacidosis (DKA) in the process of treatment for poor glycemic control with severe latent hypoglycemia. According to the standard therapy for DKA, he was treated with continuous intravenous insulin infusion therapy, which unexpectedly resulted in an abrupt and transient elevation in blood lactate levels without exacerbation of heart failure and kidney function. Since blood lactate levels are determined by the balance between lactate production and consumption, an abrupt and transient lactate elevation following intravenous insulin injection therapy may reflect not only enhanced glycolysis in insulin-sensitive tissues with mitochondrial dysfunction but also decreased lactate consumption in the sarcopenic skeletal muscle and failing heart. Intravenous insulin infusion therapy in patients with mitochondrial disease may unmask derangements of intracellular glucose metabolism in response to insulin signaling.
Case Report: Denys-Drash Syndrome With WT1 Causative Variant Presenting as Atypical Hemolytic Uremic Syndrome
Authors: Cheng Cheng, Lizhi Chen, Sijia Wen, Zhilang Lin, Xiaoyun Jiang
Journal: Front Pediatr (2020)
Keywords: atypical hemolytic uremic syndrome (ahus), case report [publication type], denys-drash syndrome (dds), pseudohermaphroditism, wilms tumor 1 gene (wt1)
MeSH terms: Case Reports

The WT1 variant is confirmed to be pathogenic for Denys-Drash syndrome (DDS), a rare disorder characterized by early-onset nephrotic syndrome and renal failure, pseudo-hermaphroditism, and a high risk of Wilms' tumor. Several cases of DDS presenting with atypical hemolytic uremic syndrome (aHUS) have been reported. Here we report the case of a 2-year-old child who was diagnosed with WT1 missense variant, associated with DDS and initial presentation of aHUS. Complement factor H autoantibodies were negative. Complement regulatory system-related gene variants were not found, but a de novo heterozygous c.754G>A missense variant in exon 9 of WT1 gene was detected, resulting in a p. Asp252Asn substitution, by next-generation sequencing. The patient was a female morphologically but proved to be a genetic male because of karyotype 46, XY with normally developed female external genitalia. Bilateral nephrectomy and renal transplantation were performed 1 year later, and there was no recurrence of aHUS at 10 months after transplantation.
Intracerebral hemorrhage associated with brucellosis: A case report
Authors: Yusong Luo, Guopeng Tian, Maoqiang Lin, Xiang Fang, Shengwei Bai, Yawen Pan
Journal: Front Neurol (2022)
Keywords: brucellosis, diagnosis, intracerebral hemorrhage, mechanisms, vascular walls
MeSH terms: Case Reports

Background:
Intracerebral hemorrhage is a common disease, but cases of intracerebral hemorrhage with brucellosis are very rare. Here, we are presenting a case of a 60-year-old male patient diagnosed with brucellosis who has a right basal ganglia hemorrhage ruptured into bilateral lateral ventricles.
Case presentation:
A 60-year-old male patient with symptoms of intracerebral hemorrhage who had no common risk factors for intracerebral hemorrhage, but having been diagnosed with brucellosis 2 months earlier and telling a shepherd history for 3 years. Cranial computed tomography (CT) and cranial magnetic resonance angiography (MRA) revealed that an intracerebral hemorrhage in the right basal ganglia had broken into bilateral lateral ventricles, and a Brucella serology test was positive. The patient's condition improved significantly after receiving bilateral lateral ventricle cone drainage, hematoma cavity cone drainage and anti-brucellosis treatment.
Conclusions:
Herein, we discuss the possible mechanisms and clinical implications between brucellosis and intracerebral hemorrhage. This case suggests whether we can use brucellosis as a routine examination for disease diagnosis and prevention in patients with intracerebral hemorrhage from pastoral areas.
Prioritizing the First Doses of SARS-CoV-2 Vaccine to Save the Elderly: The Case Study of Italy
Authors: Giuseppe Pontrelli, Giulio Cimini, Marco Roversi, Andrea Gabrielli, Gaetano Salina, Stefania Bernardi, Francesca Rocchi, Alessandra Simonetti, Carlo Giaquinto, Paolo Rossi, Francesco Sylos Labini
Journal: Front Public Health (2021)
Keywords: covid-19, sars-cov-2, elderly, prioritizing 1st dose, vaccination
MeSH terms: COVID-19, Vaccines, Aged, COVID-19 Vaccines, Europe, Humans, Italy, SARS-CoV-2, COVID-19 Vaccines, Vaccines

SARS-CoV-2 is currently causing hundreds of deaths every day in European countries, mostly in not yet vaccinated elderly. Vaccine shortage poses relevant challenges to health authorities, called to act promptly with a scarcity of data. We modeled the mortality reduction of the elderly according to a schedule of mRNA SARS-CoV-2 vaccine that prioritized first dose administration. For the case study of Italy, we show an increase in protected individuals up to 53.4% and a decrease in deaths up to 19.8% in the cohort of over 80's compared with the standard vaccine recalls after 3 or 4 weeks. This model supports the adoption of vaccination campaigns that prioritize the administration of the first doses in the elderly.
Diagnosis and Treatment of Angiography Positive Medium to Large Vessel Childhood Primary Angiitis of Central Nervous System (p-cPACNS): An International Survey
Authors: Angela S Quan, Jürgen Brunner, Benjamin Rose, Martin Smitka, Gabriele Hahn, Clare E Pain, Renate Häfner, Fabian Speth, Lucia Gerstl, Christian M Hedrich
Journal: Front Pediatr (2021)
Keywords: cns, cns inflammation, childhood, diagnosis, inflammation, pediatric, treatment, vasculitis

Childhood Primary Angiitis of Central Nervous System (cPACNS) is rare, but can cause significant damage and result in disability or even death. Because of its rarity, the sometimes acute and variable presentation, limited awareness, and the absence of widely accepted diagnostic and therapeutic standards, cPACNS is a diagnostic and therapeutic challenge. Three subcategories of cPACNS exist, including angiography-positive non-progressive p-cPACNS, angiography-positive progressive p-cPACNS which both affects the medium to large vessels, and angiography-negative small vessel sv-cPACNS. Diagnosis and treatment of cPACNS relies on personal experience, expert opinion and case reports/case series. To collect information on diagnostic and therapeutic approaches to transient and progressive cPACNS, a survey was shared among international clinicians (German Society for Pediatric Rheumatology, the Pediatric Rheumatology European Society, the German speaking "Network Pediatric Stroke," and members of the American College of Rheumatology/CARRA Pediatric Rheumatology list server). Results from this survey will be used to define statements toward a consensus process allowing harmonization of diagnostic and therapeutic approaches and the generation of evidence in a rare condition.
Congenital bilateral folds in Descemet's membrane with high astigmatism
Authors: Steffi Vande Walle, Cathérine Cassiman
Journal: GMS Ophthalmol Cases (2020)
Keywords: astigmatism, folds in descemet’s membrane, prolonged labor
MeSH terms: Case Reports

We present the case of a boy with congenital bilateral folds in Descemet's membrane, causing high astigmatism and myopia. There are multiple causes of folds and tears in Descemet's membrane. In our case, the most likely origin is the mother's prolonged labor, although a severe car accident of the mother at the gestational age of 27 weeks as the cause of these folds cannot be entirely excluded.
People living with HIV and COVID-19: A report on 2 clinical cases from South Africa
Authors: M Mitha, A P Maharaj, K Nyamande
Journal: Afr J Thorac Crit Care Med (2020)
Keywords: art, covid 19, hiv
MeSH terms: Case Reports

The impact of HIV in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has not been well established. It is uncertain if outcomes are better or worse in these patients compared with COVID-19 patients with diabetes mellitus, hypertension and other chronic diseases. The course and outcome is also unknown in HIV-positive patients who are virally suppressed on antiretroviral treatment (ART) compared with those who are treatment-naive. We present two HIV-positive cases with COVID-19 pneumonia - one virally suppressed and the other newly diagnosed. Both patients had favourable outcomes.
Olfactory delusional syndrome and intracranial meningioma
Authors: Michele Rotondo, Massimo Natale, Raffaele D'Avanzo, Assunta Scuotto
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report the case of a 37-year-old female in which the removal of a suprasellar neoplasm was accompanied by the disappearance of a longstanding olfactory delusion syndrome. In primary care the patient condition was exclusively thought to be psychic in origin, neglecting the possible, not infrequent, organic contribution. The delayed diagnosis produced neurological impairment, only partially recovered after surgical therapy. This case might help to improve the patient management via multi-specialist cooperation and to broaden the knowledge about somatic mechanisms of psychic disturbances, are not often taken into account.
Leukaemic pleural effusion as a manifestation of acute myeloid leukaemia: a case report and review of literature
Authors: Amrita Duhan, Rajnish Kalra, Hemlata T Kamra, Anand Agarwal, Parveen Rana, Ruchi Agarwal, Sanjay Verma
Journal: Ecancermedicalscience (2014)
Keywords: acute myeloid leukaemia, cytopathology, pleural effusion
MeSH terms: Case Reports

Haematologic malignancies such as acute and chronic leukaemias rarely present with or develop pleural effusion during their clinical course. We present a case of a young female who presented with unilateral pleural effusion and was diagnosed with haematologic malignancy on pleural fluid cytology. On further workup, a diagnosis of acute myeloid leukaemia was established. The patient was put on chemotherapy thereafter. This case clearly highlights the importance of cytopathology aids in making a diagnosis of rare and unusual presentation in haematologic malignancies.
Allocating scarce medical resources during armed conflict: ethical issues
Authors: Nicholas Greig Evans, Mohamed A Sekkarie
Journal: Disaster Mil Med (2017)
Keywords: allocation principle, armed conflict, healthcare worker, peritoneal dialysis, residual renal function

We describe ethical issues arising in the allocation of civilian medical resources during armed conflict. Three features are significant in the context of allocating scarce resources in armed conflicts: the distinction between continuous and binary medical resources; the risks of armed conflict itself, and the impact of cultural differences on cases of armed conflict. We use these factors to elicit a modified principle for allocating medical resources during armed conflict, using hemodialysis for patients with end-stage renal disease as a case study.
WHIM Syndrome: First Reported Case in a Patient of African Ancestry
Authors: Jinal Gandhi, Michelle H Lee, Lynsie Adams, Tara Shrout Allen, Julie Li, Camille Vanessa Edwards
Journal: Case Rep Hematol (2023)
MeSH terms: Case Reports

Background:
Warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome is a rare, primary immunodeficiency syndrome characterized by warts, hypogammaglobulinemia, immunodeficiency, and characteristic bone marrow features of myelokathexis. The pathophysiology of WHIM syndrome is due to an autosomal dominant gain of function mutation in the CXCR4 chemokine receptor resulting in increased activity that impairs neutrophil migration from the bone marrow into the peripheral blood. This results in bone marrow distinctively crowded with mature neutrophils whose balance is shifted towards cellular senescence developing these characteristic, apoptotic nuclei termed myelokathexis. Despite the resultant severe neutropenia, the clinical syndrome is often mild and accompanied by a variety of associated abnormalities that we are just beginning to understand. Case Report. Diagnosis of WHIM syndrome is incredibly difficult due to phenotypic heterogeneity. To date, there are only about 105 documented cases in the scientific literature. Here, we describe the first case of WHIM syndrome documented in a patient of African ancestry. The patient in question was diagnosed at the age of 29 after a comprehensive work-up for incidental neutropenia discovered at a primary care appointment at our center in the United States. In hindsight, the patient had a history of recurrent infections, bronchiectasis, hearing loss, and VSD repair that could not be previously explained.
Conclusions:
Despite the challenge of timely diagnosis and the wide spectrum of clinical features that we are still discovering, WHIM syndrome tends to be a milder immunodeficiency that is highly manageable. As presented in this case, most patients respond well to G-CSF injections and newer treatments such as small-molecule CXCR4 antagonists.
Delayed Vision Recovery after Carotid Vascular Surgery for Branch Retinal Artery Occlusion
Authors: Jessica Ruzicki, Eric K Chin, David Almeida
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Branch retinal artery occlusion (BRAO) is typically associated with irreversible vision and peripheral visual field loss. We report a case of a 62-year-old woman with a BRAO related to several cardiovascular risk factors. Our patient encountered gradual but significant vision recovery months following carotid artery endarterectomy for carotid stenosis.
A Novel CAPN1 Mutation Causes a Pure Hereditary Spastic Paraplegia in an Italian Family
Authors: Stefano Cotti Piccinelli, Maria T Bassi, Andrea Citterio, Fiore Manganelli, Stefano Tozza, Filippo M Santorelli, Serena Gallo Cassarino, Filomena Caria, Enrico Baldelli, Anna Galvagni, Lucio Santoro, Alessandro Padovani, Massimiliano Filosto
Journal: Front Neurol (2019)
Keywords: capn1, hsp, sca, ataxia, calpain-1, hereditary spastic paraplegia, spinocerebellar ataxia
MeSH terms: Case Reports

CAPN1 encodes calpain-1, a large subunit of μ-calpain, a calcium-activated cysteine protease widely present in the central nervous system. Mutations in CAPN1 have recently been identified in a complicated form of Hereditary Spastic Paraplegia (HSP) with a combination of cerebellar ataxia and corticomotor tract disorder (SPG76). Therefore, CAPN1 is now considered one of those genes that clinically manifest with a spectrum of disorders ranging from spasticity to cerebellar ataxia and represent a link between Spinocerebellar Ataxia and HSP, two groups of diseases previously considered separate but sharing pathophysiological pathways. We here describe clinical and molecular findings of two Italian adult siblings affected with a pure form of HSP and harboring the novel homozygote c.959delA variant (p.Tyr320Leufs*73) in the CAPN1 gene. Although the reason why mutations in CAPN1 may cause heterogeneous clinical pictures remains speculative, our findings confirm that the spectrum of the CAPN1-linked phenotypes includes pure HSP with onset during the third decade of life. Further studies are warrantied in order to clarify the mechanism underlying the differences in CAPN1 mutation clinical expression.