OpenMed/multicare-articles huggingface dataset:
Case report: Short-long-short mechanism triggering sustained ventricular tachycardia in a patient with a single-chamber ICD but inhibiting antitachycardia therapy
Authors: Christiana Schernthaner, Albert Topf, Lukas J Motloch, Johannes Kraus, Laurenz Hauptmann, Uta C Hoppe, Bernhard Strohmer
Journal: Front Cardiovasc Med (2022)
Keywords: antitachycardia pacing, antitachycardia therapy, cardiomyopathy, implantable cardioverter defibrillator, ventricular tachycardia
MeSH terms: Case Reports

Introduction:
Short-long-short (SLS) sequences are an important cause of ICD pro-arrhythmia and can initiate both polymorphic and monomorphic ventricular tachycardias (VT). Depending on the programming of a single-chamber ICD, the interplay between SLS sequences and combined VT detection criteria can be responsible for withholding adequate anti-tachycardia pacing (ATP) or shock therapy.
Methods:
A 78-year-old patient with ICD was admitted to our emergency department after external cardioversion of a long-lasting VT with hemodynamic compromise. The interrogation of the ICD revealed an SLS sequence initiating a monomorphic VT at a rate of 171 bpm (350 ms). The VT discrimination of the implanted single-chamber ICD was based on the onset and stability criteria as the patient had a history of paroxysmal atrial fibrillation. The ICD was programmed that both criteria had to be met for VT detection and initiation of anti-tachycardia therapy.
Results:
Due to the SLS sequence in combination with the programmed VT detection interval, the onset threshold was not fulfilled and inhibited adequate therapy. Some relatively slow VT beats following the SLS sequence resulted finally in a considerable delay in the declaration of the episode onset. As a first step, the threshold for VT detection was programmed to 150 instead of 160 bpm. To avoid SLS sequences and pause-dependent ventricular tachyarrhythmias, VVI backup stimulation was increased from 35 to 55 ppm. Besides, a device-specific algorithm called rate smoothing was activated as a potential preventive feature. On the 3-month follow-up, all sustained VT episodes were detected adequately by the reprogrammed device, resulting in appropriate anti-tachycardia pacing. After further refinement and less aggressive programming of rate smoothing, the patient remained free of symptoms and arrhythmias over a follow-up of more than 2.5 years, particularly since progression to permanent atrial fibrillation and pacing at a lower rate of 60 ppm.
Conclusions:
SLS sequences may initiate or trigger VT episodes. Misclassification of the true onset may occur in some ICD devices due to specific programming of VT detection criteria. If both criteria "Onset and Stability" have to be fulfilled, ICD therapy is not delivered despite ongoing VT. Anti-bradycardia backup pacing at a very low stimulation rate may facilitate SLS sequences in patients with ICD resembling a potential pro-arrhythmic mechanism. In case of gradual VT onset with some intervals slower than the programmed VT threshold, the detection rate has to be adjusted down to guarantee appropriate identification of the onset.
Transperineal MRI-US Fusion-Guided Target Biopsy of the Prostate after Abdominoperineal Resection: A Case Report
Authors: Nando De Vulder, Koen Geldof, Frederic Baekelandt, Katrien Gieraerts
Journal: J Belg Soc Radiol (2021)
Keywords: abdominoperineal resection, case reports, mri-us fusion, prostate cancer, target biopsy
MeSH terms: Case Reports

Main Teaching Point: MRI-US fusion-guided transperineal prostate biopsy can help sampling clinically relevant prostate cancer in patients with a history of abdominoperineal resection and is feasible under local anaesthesia and in an outpatient setting. Prostate cancer remains one of the most diagnosed cancers in men worldwide. Prostate biopsy in patients with a history of abdominoperineal resection poses a serious challenge since transrectal ultrasound is not possible. Several techniques have been described with their respective limitations and risks. This report of such a patient aged 75, presents a Magnetic Resonance Imaging-Ultrasound fusion-guided transperineal approach to prostate biopsy which can be performed under local anaesthesia and in an outpatient setting.
Acute paraumbilical vein recanalization: an unusual complication of acute pancreatitis
Authors: R J Foster, G W Cowell
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Acute pancreatitis is associated with a number of well-known complications and imaging findings. Spontaneous recanalization of the paraumbilical veins as a consequence of pancreatitis in a patient with an otherwise normal liver is, however, a rare entity. This case report depicts this unusual complication as a consequence of gallstone pancreatitis in a patient with a non-cirrhotic liver and no clinical or radiological evidence of portal hypertension. There was recanalization of the paraumbilical veins followed by thrombosis, which is believed to have propagated in a retrograde fashion into distal branches of the otherwise patent portal vein. A literature search for similar cases such as this has yielded no results. Although rare, clinicians and radiologists alike need to be aware of this finding. This case discussion highlights the embryology and anatomy of the paraumbilical veins, as well as discusses the management of paraumbilical and portal vein thrombosis.
Cervical Subcutaneous Emphysema following Total Laryngectomy: An Unusual Complication of Nasogastric Intubation
Authors: Guled M Jama, Behrad Barmayehvar, Sanjay Vydianath, John Mathews, Catherine Spinou
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

The nasogastric tube remains an important route of enteral feeding in the early postoperative period following total laryngectomy. Its insertion, however, is not without any risks of complications. In this article, we report an unusual case of inadvertent nasopharyngeal perforation secondary to intraoperative nasogastric tube insertion presenting as unilateral cervical subcutaneous emphysema in a patient who underwent total laryngectomy.
Reiter's syndrome following intravesical Bacillus Calmette-Guerin therapy for bladder carcinoma: Case report
Authors: Hajar Aown Allah Alsulami, Omar Al-Nashiwaty, Mahassen Aly Khalifa, Nazar Ulla Syed, Noha Ahmed, Souad Almuthree
Journal: IDCases (2023)
MeSH terms: Case Reports

Reiter syndrome is an autoimmune condition that develops in as a reactive response to GI or GU related infectious and rarely related to Intravesical BCG. it is a triad of conjunctivitis, urethritis, and arthritis. Here we report the case of a female patient who developed acute Reiter's syndrome following intravesical Bacillus Calmette-Guerin (BCG) immunotherapy for superficial bladder cancer. After the sixth dose in the maintenance phase of treatment the patient developed conjunctivitis, aseptic urethritis, and polyarthritis consistent with a diagnosis of Reiter's syndrome. In this patient non-steroidal anti-inflammatory drugs (NSAIDs), oral steroids and anti-tuberculosis drugs were administered with complete resolution of symptoms.
A new adult AML case with an extremely complex karyotype, remission and relapse combined with high hyperdiploidy of a normal chromosome set in secondary AML
Authors: Abdulsamad Wafa, Suher ALmedania, Abdulmunim Aljapawe, Thomas Liehr, Soulaiman E Soulaiman, Raja Mouna, Moneeb A K Othman, Walid ALachkar
Journal: BMC Hematol (2018)
Keywords: acute myeloid leukemia, array comparative genomic hybridization (acgh), complex karyotype, high hyperdiploidy, molecular cytogenetics, pentasomy 4, prognostic factors
MeSH terms: Case Reports

Background:
Chromosomal abnormalities are diagnostic and prognostic key factors in acute myeloid leukemia (AML) patients, as they play a central role for risk stratification algorithms. High hyperdiploidy (HH), a rare cytogenetic abnormality seen commonly in elder male AML patients, is normally categorized under AML with complex karyotype (CK). Accordingly, patients with HH generally are associated with low remission rates and a short overall survival.
Case presentation:
Here we report a case of 21-year-old female, diagnosed with a de novo AML-M1 according to WHO classification and a CK at diagnosis. Cytogenetic, molecular cytogenetic approaches (standard fluorescence in situ hybridization (FISH), array-proven multicolor banding (aMCB)) and high resolution array comparative genomic hybridization (aCGH) analyses revealed a unique complex but still near diploid karyotype involving eleven chromosomes was identified. It included pentasomy 4, three yet unreported chromosomal aberrations t(1;2)(p35;p22), t(1;3)(p36.2;p26.2), and t(10;12)(p15.2;q24.11), and a combination of two cytogenetic events, yet unreported to appear in together, i.e. a reciprocal translocation t(1;3)(p36.2;p26.2) leading to EVI1/PRDM16 gene fusion, and monoallelic loss of tumor suppressor gene TP53. After successful chemotherapeutic treatment the patient experienced a relapse to AML-M1, and she developed secondary AML-M6 with tetraploidy and HH. Unfortunately, the young woman died 8.5 months after initial diagnosis.
Conclusions:
To the best of our knowledge, a comparable adult AML associated with such a CK, coexistence of 3q rearrangements with loss of TP53 at diagnosis, and HH in secondary AML were not previously reported. Thus, the combination of the here seen chromosomal aberrations in adult primary AML seems to indicate for an adverse prognosis.
Being Through Doing: The Self-Immolation of an Asylum Seeker in Switzerland
Authors: Gail Womersley, Laure Kloetzer
Journal: Front Psychiatry (2018)
Keywords: dialogical analysis, immigrants, self-immolation, social recognition, trauma
MeSH terms: Case Reports

In April 2016, Armin, an asylum seeker in a village of Switzerland, set himself alight in the public square of the town, one of a few cases reported across Europe. He performed the act following a denied request for asylum and was saved by bystanders. We present the results of two qualitative interviews conducted with Armin, his translator and his roommate following the incident. The act is theorized through the lens of a dialogical analysis focusing on the concept of social recognition. The notion of trauma is considered as a key mediating mechanism, theorized as creating ruptures in time, memory, language, and social connections to an Other. We conclude this communicative act to represent both "being-toward-death" and a relational striving toward life; a "destruction as the cause of coming into being."
A Case of Bisphosphonate-Related Osteonecrosis of the Jaw in a Patient with Subpontic Osseous Hyperplasia
Authors: Chiaki Tsuji, Hiroshi Watanabe, Hidenori Nakayama, Mitsuo Goto, Kenichi Kurita
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Subpontic osseous hyperplasia (SOH) is a growth of bone occurring on the edentulous ridge beneath the pontics of fixed partial dentures (FPDs). This report describes a case of bisphosphonate- (BP-) related osteonecrosis of the jaw (BRONJ) in a SOH patient followed by deciduation of the bony lesion. A 73-year-old woman visited a dental clinic after experiencing pain and swelling beneath the pontics of a FPD that had been inserted 15 years ago. The pontics were removed, but the symptoms persisted and she was referred to our hospital. There was an osseous bulge and gum swelling around the edentulous ridge of teeth 18 and 19, as well as bone exposure. As she had been taking an oral BP for 6 years, we diagnosed this case as stage 2 BRONJ. Following BP withdrawal, the bony lesion detached from the mandible. The tissue was diagnosed as sequestrum based on the histopathological findings. Two months after deciduation, epithelialization over the area of exposed bone was achieved and no recurrence has been observed.
The Application of a SaCoVLMTM Visual Intubation Laryngeal Mask for the Management of Difficult Airways in Morbidly Obese Patients: Case Report
Authors: Yongtao Sun, Linlin Huang, Lingling Xu, Min Zhang, Yongle Guo, Yuelan Wang
Journal: Front Med (Lausanne) (2021)
Keywords: sacovlmtm, difficult airways, laryngeal mask airway, morbidly obese patients, visual intubation laryngeal mask
MeSH terms: Case Reports

We report insertion of the SaCoVLMTM in three awake morbidly obese patients (BMI 46. 7-52.1 kg/m2). The patients were given intravenous atropine and midazolam injections after entering the operating room and then inhaled an anesthetic with 2% lidocaine atomization. After SaCoVLMTM insertion while patients were awake, when the vocal cords were visualized, controlled anesthetic induction commenced with spontaneous ventilation. The entire anesthesia induction and intubation process was completed under visualization, and no adverse events such as hypoxemia occurred. No patient had an unpleasant recall of the procedure. We conclude that the SaCoVLMTM is easy to use, well tolerated and suitable for awake orotracheal intubation in patients with known difficult airways.
First COVID-19 infections in the Philippines: a case report
Authors: Edna M Edrada, Edmundo B Lopez, Jose Benito Villarama, Eumelia P Salva Villarama, Bren F Dagoc, Chris Smith, Ana Ria Sayo, Jeffrey A Verona, Jamie Trifalgar-Arches, Jezreel Lazaro, Ellen Grace M Balinas, Elizabeth Freda O Telan, Lynsil Roy, Myvie Galon, Carl Hill N Florida, Tatsuya Ukawa, Annavi Marie G Villaneuva, Nobuo Saito, Jean Raphael Nepomuceno, Koya Ariyoshi, Celia Carlos, Amalea Dulcene Nicolasora, Rontgene M Solante
Journal: Trop Med Health (2020)
Keywords: covid-19, case report, coronavirus, manila, philippines, sars-cov-2
MeSH terms: Case Reports

Background:
The novel coronavirus (COVID-19) is responsible for more fatalities than the SARS coronavirus, despite being in the initial stage of a global pandemic. The first suspected case in the Philippines was investigated on January 22, 2020, and 633 suspected cases were reported as of March 1. We describe the clinical and epidemiological aspects of the first two confirmed COVID-19 cases in the Philippines, both admitted to the national infectious disease referral hospital in Manila.
Case presentation:
Both patients were previously healthy Chinese nationals on vacation in the Philippines travelling as a couple during January 2020. Patient 1, a 39-year-old female, had symptoms of cough and sore throat and was admitted to San Lazaro Hospital in Manila on January 25. Physical examination was unremarkable. Influenza B, human coronavirus 229E, Staphylococcus aureus and Klebsiella pneumoniae were detected by PCR on initial nasopharyngeal/oropharyngeal (NPS/OPS) swabs. On January 30, SARS-CoV-2 viral RNA was reported to be detected by PCR on the initial swabs and she was identified as the first confirmed COVID-19 case in the Philippines. Her symptoms resolved, and she was discharged. Patient 2, a 44-year-old male, had symptoms of fever, cough, and chills. Influenza B and Streptococcus pneumoniae were detected by PCR on initial NPS/OPS swabs. He was treated for community-acquired pneumonia with intravenous antibiotics, but his condition deteriorated and he required intubation. On January 31, SARS-CoV-2 viral RNA was reported to be detected by PCR on the initial swabs, and he was identified as the 2nd confirmed COVID-19 infection in the Philippines. On February 1, the patient's condition deteriorated, and following a cardiac arrest, it was not possible to revive him. He was thus confirmed as the first COVID-19 death outside of China.
Conclusions:
This case report highlights several important clinical and public health issues. Despite both patients being young adults with no significant past medical history, they had very different clinical courses, illustrating how COVID-19 can present with a wide spectrum of disease. As of March 1, there have been three confirmed COVID-19 cases in the Philippines. Continued vigilance is required to identify new cases.
Low-Grade Mucoepidermoid Carcinoma of the Lacrimal Gland in a Teenaged Patient
Authors: Ozgun Melike Gedar Totuk, Mustafa Kemal Demir, Ozlem Yapicier, Mert Mestanoglu
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Mucoepidermoid carcinoma is the most common malignant, locally invasive tumour of the salivary glands and accounts for approximately 35% of all malignancies of the major and minor salivary glands. Mucoepidermoid carcinoma that originated from the lacrimal gland is exceedingly rare in teenage patients, with only a few cases reported. Herein, we report clinical and radiological findings of a mucoepidermoid carcinoma arising from the lacrimal gland in a 15-year-old boy. We suggest that since preoperative imaging findings are not diagnostic for mucoepidermoid carcinoma, histopathologic examination should be performed for definitive diagnosis. Complete surgical resection is the treatment of choice for low-grade lacrimal gland mucoepidermoid carcinoma.
Polymorphous acral eruption and Covid-19
Authors: Youness Elkhachine, Abdessamad Sakkah, Ihssane Hallab, Abderrazak Jakar, Mohamed Elhaouri, Jalal Elbenaye
Journal: Pan Afr Med J (2020)
Keywords: covid-19, acral eruption, immunological, polymorphous, skin, young
MeSH terms: COVID-19 / complications, Skin / pathology, Skin Diseases, Viral / diagnosis, Case Reports, Adolescent, COVID-19 / diagnosis, Female, Humans, Male, Skin / virology, Skin Diseases, Viral / pathology, Skin Diseases, Viral / virology, Young Adult

Clinical manifestations associated with covid-19 seem to be not limited to the lungs and widen to affect several organs including skin. Through two cases well documented, we report cutaneous manifestations strongly suggestive of Covid-19 which dermatologists are beginning to report worldwide and which we proposed to call them polymorphous acral eruption.
Sacituzumab govitecan and radiotherapy in metastatic, triple-negative, and BRCA-mutant breast cancer patient with active brain metastases: A case report
Authors: Pierluigi di Mauro, Greta Schivardi, Rebecca Pedersini, Lara Laini, Andrea Esposito, Vito Amoroso, Marta Laganà, Salvatore Grisanti, Deborah Cosentini, Alfredo Berruti
Journal: Front Oncol (2023)
Keywords: brca2, antibody-drug conjugate, brain metastases, sacituzumab govitecan, triple-negative breast cancer
MeSH terms: Case Reports

Background:
Triple-negative breast cancer (TNBC) is an aggressive cancer subtype, owing to its high metastatic potential: Patients who develop brain metastases (BMs) have a poor prognosis due to the lack of effective systemic treatments. Surgery and radiation therapy are valid options, while pharmacotherapy still relies on systemic chemotherapy, which has limited efficacy. Among the new treatment strategies available, the antibody-drug conjugate (ADC) sacituzumab govitecan has shown an encouraging activity in metastatic TNBC, even in the presence of BMs.
Case presentation:
A 59-year-old woman was diagnosed with early TNBC and underwent surgery and subsequent adjuvant chemotherapy. A germline pathogenic variant in BReast CAncer gene 2 (BRCA2) was revealed after genetic testing. After 11 months from the completion of adjuvant treatment, she had pulmonary and hilar nodal relapse and began first-line chemotherapy with carboplatin and paclitaxel. However, after only 3 months from starting the treatment, she experienced relevant disease progression, due to the appearance of numerous and symptomatic BMs. Sacituzumab govitecan (10 mg/kg) was started as second-line treatment as part of the Expanded Access Program (EAP). She reported symptomatic relief after the first cycle and received whole-brain radiotherapy (WBRT) concomitantly to sacituzumab govitecan treatment. The subsequent CT scan showed an extracranial partial response and a near-to-complete intracranial response; no grade 3 adverse events were reported, even if sacituzumab govitecan was reduced to 7.5 mg/kg due to persistent G2 asthenia. After 10 months from starting sacituzumab govitecan, a systemic disease progression was documented, while intracranial response was maintained.
Conclusions:
This case report supports the potential efficacy and safety of sacituzumab govitecan in the treatment of early recurrent and BRCA-mutant TNBC. Despite the presence of active BMs, our patient had a progression-free survival (PFS) of 10 months in the second-line setting and sacituzumab govitecan was safe when administered together with radiation therapy. Further real-world data are warranted to confirm sacituzumab govitecan efficacy in this patient population.
Intracranial Arteriovenous Malformation Combined with Multiple Aneurysms Diagnosed by CTA: A Case Report
Authors: Qin Zhang, Yongzhe Hou, Qiong Wang, Xilong Chen
Journal: J Belg Soc Radiol (2023)
Keywords: aneurysm, arteriovenous malformation, cerebral, computed tomography angiography, intracranial
MeSH terms: Case Reports

Arteriovenous malformation (AVM) combined with aneurysms is not uncommon, but AVM of the basilar artery, brainstem, and right middle cerebral artery combined with multiple intracranial aneurysms (IAs) is rare. Cases of aneurysm protrusion into the optic canal are also rare. We report a distinctive case of intracranial AVM combined with multiple IAs and partial protrusion of a cavernous segment aneurysm of the right internal carotid artery into the optic nerve canal.
Teaching point:
Cases of partial protrusion of a cavernous segment aneurysm of the right internal carotid artery into the optic canal, resulting in widening of the optic canal compared to the contralateral side, compression, thickening and swelling of the subocular veins, and obstruction of venous drainage warrant the clinician's attention.
Case Report: Japanese Siblings of Cystic Fibrosis With a Novel Large Heterozygous Deletion in the CFTR Gene
Authors: Mayumi Kawase, Masato Ogawa, Takayuki Hoshina, Masumi Kojiro, Miyuki Nakakuki, Satoru Naruse, Hiroshi Ishiguro, Koichi Kusuhara
Journal: Front Pediatr (2022)
Keywords: asz1 gene, cystic fibrosis, multiplex ligation-dependent probe amplification (mlpa), novel variant, promoter region (genetics)
MeSH terms: Case Reports

Cystic fibrosis (CF) is a rare disease in the Japanese. The most common CFTR variant in Japanese CF patients is a large heterozygous deletion that can easily avoid detection by standard gene sequencing methods. We herein report a novel large heterozygous deletion in the CFTR gene in Japanese siblings with CF. A genetic analysis was performed in two patients (9-year-old boy and 5-month-old girl) who were clinically diagnosed with CF because of the positive result for the rapid fecal pancreatic elastase antigen test and the elevation of the sweat chloride concentration. In addition to conventional polymerase chain reaction (PCR) and direct sequencing, multiplex ligation-dependent probe amplification (MLPA) was performed to check for a large deletion and duplication of the CFTR gene. Based on MLPA findings, the breakpoint of heterozygous deletion was identified by real-time quantitative PCR followed by the sequence of the amplified junction fragment. In MLPA, the numbers of the fragments corresponding to exons 1, 16, 17a, and 17b and 234 nt and 747 nt upstream from the translation initiation codon of exon 1 in the CFTR gene and exon 3 in the ASZ1 gene were reduced by almost half. The c.2908+1085_3367+260del7201 variant (exon 16-17b deletion) was identified in one allele. The other allele had a large 137,567-bp deletion from g.117,361,112 (ASZ1 3' flanking region) to g.117,498,678 (CFTR intron 1) on chromosome 7. Since the deletion variant lacked the entire promoter region of CFTR, CFTR mRNA would not be transcribed from the allele, indicating it to be a novel pathogenic variant causing CF. As large mutations are frequently detected in Japanese CF patients, MPLA can be useful when searching for variants.