OpenMed/multicare-articles huggingface dataset:
Cyanoacrylate Associated Foreign Body Granulomatous Gastritis: A Report of Three Cases
Authors: Gunes Guner, Olcay Kurtulan, Taylan Kav, Cenk Sokmensuer, Gokhan Gedikoglu, Aytekin Akyol
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Granulomas are rarely seen in gastric biopsies mostly as an involvement of granulomatous diseases like sarcoidosis, Crohn's disease, infections, neoplasms, and vasculitis. Here, we claim cyanoacrylate as a foreign body type granuloma-causing agent in the stomach after vascular embolisation. We present cyanoacrylate associated gastric changes of three cases: two endoscopic biopsies and one gastric resection. In two cases, cyanoacrylate associated ulcers and granulomatous inflammation were observed in gastric mucosal biopsies following endoscopic examination after 7 months and 6 years of the glue injections, respectively. In the third case, the cyanoacrylate injection was performed 2 months prior to the surgery. Then the patient underwent distal pancreatectomy for pancreatic adenocarcinoma and during the operation a gastric mass was resected with a suspicion of tumoral infiltration. These three cases demonstrated that glue exposure causes active chronic inflammation with foreign body type granulomas, mucosal ulceration, and bleeding in the gastric mucosa. Even further, it can induce mass formation in the injection sites.
SCN5A Nonsense Mutation and NF1 Frameshift Mutation in a Family With Brugada Syndrome and Neurofibromatosis
Authors: Emanuele Micaglio, Michelle M Monasky, Giuseppe Ciconte, Gabriele Vicedomini, Manuel Conti, Valerio Mecarocci, Luigi Giannelli, Federica Giordano, Alberto Pollina, Massimo Saviano, Simonetta Crisà, Valeria Borrelli, Andrea Ghiroldi, Sara D'Imperio, Chiara Di Resta, Sara Benedetti, Maurizio Ferrari, Vincenzo Santinelli, Luigi Anastasia, Carlo Pappone
Journal: Front Genet (2019)
Keywords: brugada syndrome, nf1, scn5a, arrhythmia, genetic testing, mutation, neurofibromatosis type 1, sudden cardiac death
MeSH terms: Case Reports

In this case series, we report for the first time a family in which the inherited nonsense mutation [c. 3946C > T (p.Arg1316*)] in the SCN5A gene segregates in association with Brugada syndrome (BrS). Moreover, we also report, for the first time, the frameshift mutation [c.7686delG (p.Ile2563fsX40)] in the NF1 gene, as well as its association with type 1 neurofibromatosis (NF1), characterized by pigmentary lesions (café au lait spots, Lisch nodules, freckling) and cutaneous neurofibromas. Both of these mutations and associated phenotypes were discovered in the same family. This genetic association may identify a subset of patients at higher risk of sudden cardiac death who require the appropriate electrophysiological evaluation. This case series highlights the importance of genetic testing not only to molecularly confirm the pathology but also to identify asymptomatic family members who need clinical examinations and preventive interventions, as well as to advise about the possibility of avoiding recurrence risk with medically assisted reproduction.
Left-sided appendicitis due to anatomical variation: A case report
Authors: Qiang Hu, Jianfeng Shi, Yuanshui Sun
Journal: Front Surg (2022)
Keywords: abdominal pain, acute appendicitis, case report, intestinal malrotation, left side
MeSH terms: Case Reports

Introduction:
Left-sided appendicitis is a rare condition, and we report a patient with left abdominal heterotopia of the right colon complicated by acute appendicitis in the left lower quadrant.
Case presentation:
A 39-year-old male was admitted to hospital following left lower abdominal pain for 1 day. Imaging examination by abdominal CT showed that the appendix was not clearly seen, and a mass was found in the left lower abdomen. Because the patient's abdominal pain was severe and the current diagnosis was not clear, after soliciting the patient's consent, we performed laparoscopic exploration. This exploration revealed that the cecum and ascending colon were located in the left iliac fossa, the appendix was swollen, the length of the appendix was approximately 6 cm, the diameter of the appendix was approximately 1 cm, and there was pus moss attached to the surface. We performed a laparoscopic appendectomy; the procedure was uneventful and the patient was discharged 3 days after the procedure.
Conclusion:
Left-sided appendicitis is a rare condition and is therefore easy to misdiagnose. Wrong diagnosis can lead to serious complications and endanger the patient's life. Therefore, a full combination of laboratory tests and CT scan is required. If still no diagnosis can be made correctly, a laparoscopic exploration needs to be performed in a timely manner. This case teaches us that when we encounter a patient with severe left abdominal pain that cannot be definitely diagnosed, we need to be vigilant and perform timely laparoscopic exploration when necessary.
Aquagenic urticaria in twins
Authors: Anneke C Kai, Carsten Flohr
Journal: World Allergy Organ J (2013)
MeSH terms: Case Reports

We describe the case of 18 year old twin brothers who presented to our unit with a 3 year history of aquagenic urticaria. This rare form of urticaria usually presents within an hour of contact with water. The aetiology is unknown. Most cases are sporadic but there are a small number of familial cases in the medical literature. A specific genetic mutation has not yet been found. To our knowledge, this is the first report of aquagenic urticaria in monozygotic twins, further supporting a genetic component to this disease.
Management of Combined Cardiac Surgery Using Cardiopulmonary Bypass With Acute Normovolemic Hemodilution in a Jehovah's Witness: A Case Report
Authors: Takayuki Morimoto, Taiga Ichinomiya, Hiroaki Murata, Motohiro Sekino, Tetsuya Hara
Journal: Cureus (2023)
Keywords: acute normovolemic hemodilution, cardiopulmonary bypass, combined cardiac surgery, jehovah’s witness, preoperative hematopoiesis
MeSH terms: Case Reports

Combined cardiac surgery under cardiopulmonary bypass (CPB) has a high risk of requiring blood transfusion. Performing this surgery on Jehovah's Witnesses (JWs) is challenging as they strictly refuse allogeneic blood transfusions due to their religious beliefs. A 73-year-old female JW patient underwent combined surgery involving coronary artery bypass grafting and mitral valvuloplasty under CPB. Preoperative hematopoiesis maintained the hemoglobin (Hb) level at >12 g/dL preoperatively; the Hb level was maintained at >7 g/dL during CPB for effective acute normovolemic hemodilution (ANH). Compared with the values obtained immediately after CPB weaning, the Hb level and coagulation functions (measured using viscoelastic tests) improved after autologous transfusion at the end of the surgery. When cardiac surgery under CPB is performed on JWs, ANH can be useful for maintaining postoperative Hb levels and coagulation factors. Sufficient preoperative hematopoiesis and determination of an appropriate volume for intraoperative ANH may be important for effective ANH.
Epidural Analgesia with Ropivacaine during Labour in a Patient with a SCN5A Gene Mutation
Authors: A L M J van der Knijff-van Dortmont, M Dirckx, J J Duvekot, J W Roos-Hesselink, A Gonzalez Candel, C D van der Marel, G P Scoones, V F R Adriaens, I J J Dons-Sinke
Journal: Case Rep Anesthesiol (2016)

SCN5A gene mutations can lead to ion channel defects which can cause cardiac conduction disturbances. In the presence of specific ECG characteristics, this mutation is called Brugada syndrome. Many drugs are associated with adverse events, making anesthesia in patients with SCN5A gene mutations or Brugada syndrome challenging. In this case report, we describe a pregnant patient with this mutation who received epidural analgesia using low dose ropivacaine and sufentanil during labour.
Posttraumatic checkrein deformity following isolated Lauge-Hansen pronation external rotation stage IV malleolar fracture-a case report and literature review
Authors: Wen-Tao Chen, Zhen-Yu Liu, Bao-Jun Wang
Journal: Front Surg (2023)
Keywords: lauge–hansen, adhesion, checkrein deformity, flexor hallucis longus, malleolar fracture
MeSH terms: Case Reports

The checkrein deformity is characterized by flexion contracture of the interphalangeal joint and extension contracture of the metatarsophalangeal joint. It is a rare condition occurring after lower extremity trauma, especially a malleolar fracture. Little is known about the possible cause and therapeutic strategy. This unique case presents a 20-year-old male patient with a diagnosis of the checkrein deformity secondary to open reduction and internal fixation of a Lauge-Hansen pronation external rotation stage IV malleolar fracture. After performing a detailed physical examination, radiographic evaluation, and ultrasonography, open exploration was performed to remove the hardware and correct the deformity with sole tenolysis of the flexor hallucis longus (FHL). In the 4-month follow-up, no recurrence of the checkrein deformity was observed. This deformity was caused by FHL adhesion. Interosseous membrane injury and fibular fracture together with local hematomas increases the risk of FHL adhesion. Open exploration and tenolysis of the FHL are feasible options to correct the checkrein deformity.
An Overlooked Cause of Myocardial Infarction With Normal Coronaries Presenting as Stress Cardiomyopathy in Females
Authors: Annapoorna Singh, Krishna Patel, Femina Patel, John T Saxon, Anna Grodzinsky
Journal: Cureus (2023)
Keywords: cardiac chest pain, scad, scad management, spontaneous coronary artery dissection, stress cardiomyopathy, takotsubo cardiomyopathy
MeSH terms: Case Reports

Spontaneous coronary artery dissection (SCAD) should be considered in the differential diagnosis of patients with provisional Takotsubo cardiomyopathy (TTS). However, because of overlapping clinical features, SCAD with subtle angiographic findings and wall motion abnormality like TTS can be easily missed. Therefore, our case highlights the importance of further investigation for SCAD.
ARDS and Massive Pulmonary Embolism: The Combined Use of Extracorporeal Membrane Oxygenation (ECMO) with Thrombolytics
Authors: Brett Dickens, Casey Bryant, John Gaillard, Nathaniel Westphal
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Pancreatitis causes a systemic inflammatory response that can lead to acute respiratory distress syndrome (ARDS). We present a case of severe ARDS complicated by a pulmonary embolism (PE) in a 39-year-old female that developed rapidly progressive pancreatitis secondary to hypertriglyceridemia.
Usefulness of central venous saturation as a predictor of thiamine deficiency in critically ill patients: a case report
Authors: Genri Numata, Satoshi Kodera, Hiroyuki Kiriyama, Atsuko Nakayama, Eisuke Amiya, Arihiro Kiyosue, Masaru Hatano, Eiki Takimoto, Masafumi Watanabe, Issei Komuro
Journal: J Intensive Care (2017)
Keywords: beriberi, central venous catheter, diuretics, oxygen consumption, shock, thiamine
MeSH terms: Case Reports

Background:
Central venous oxygen saturation (ScvO2) reflects the balance of oxygen delivery and consumption. Low ScvO2 indicates the presence of inadequate oxygen delivery, while high ScvO2 indicates reduced oxygen consumption and is sometimes associated with a high mortality rate in critically ill patients from dysoxia. Thiamine is an essential cofactor in cellular aerobic metabolism. Thiamine deficiency is more prevalent than was previously thought, and underlies severe conditions in critically ill patients. However, currently, there is no rapid diagnostic test for thiamine deficiency. Considering oxygen flux, high ScvO2 might be associated with thiamine deficiency.
Case presentation:
A 70-year-old man admitted to the hospital with chief complaint of malaise and edema. He was diagnosed with heart failure with preserved ejection function and was treated with loop diuretics, which resulted in shock. Venoarterial extracorporeal membrane oxygenation and intra-aortic balloon pumping was indicated. The right heart catheter showed high ScvO2, normal cardiac output, and low systemic vascular resistance. Thiamine deficiency was suspected and we started the thiamine infusion. His hemodynamic status improved after thiamine replacement. After his recovery, it was discovered that he had a 1-month history of anorexia and thiamine deficiency. His final diagnosis was beriberi.
Conclusions:
The current case showed the relation between thiamine deficiency and high ScvO2. A literature review also suggested that thiamine deficiency is associated with high ScvO2. Thiamine deficiency causes impaired tissue oxygen extraction, which could lead to high ScvO2. In this context, high ScvO2 might serve as a predictor of thiamine deficiency in critically ill patients.
Successful Surgical Therapy of a Double Aortic Arch in a 10-Month-Old Mixed Breed Dog
Authors: Christelle M Follette, Alex Terreros, Sheldon L Padgett
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

A 10-month-old female spayed mixed breed dog with a suspected vascular ring anomaly was presented for exercise intolerance and wheezing. Computed tomography (CT) revealed a double aortic arch. The smaller right aortic arch was successfully ligated via right 4th intercostal thoracotomy. The patient was discharged one day postoperatively and continued to have good outcome at recheck 3.5 weeks after surgery. This is the 4th documented case of double aortic arch with a successful outcome. Preoperative CT scan was vital in preoperative planning and should be strongly recommended in all cases of suspected vascular ring anomalies with atypical presentation.
Adrenocorticotropic hormone (ACTH) independent Cushing's syndrome due to unilateral adrenocortical hyperplasia: two case reports
Authors: Yousra Aouinati, Amal Mjabber, Nassim Essabah Haraj, Siham El Aziz, Asmaa Chadli
Journal: Pan Afr Med J (2021)
Keywords: cortisol, adrenocorticotropic hormone-independent cushing syndrome, case report, macronodular hyperplasia
MeSH terms: Adrenal Gland Diseases / complications, Adrenalectomy / methods, Cushing Syndrome / diagnosis, Case Reports, Adenoma / diagnosis, Adrenal Gland Diseases / surgery, Adrenocorticotropic Hormone / metabolism, Cushing Syndrome / etiology, Cushing Syndrome / surgery, Female, Humans, Hyperplasia, Laparoscopy, Middle Aged, Tomography, X-Ray Computed, Adrenocorticotropic Hormone

Adrenal unilateral macronodular hyperplasia is a rare cause of Cushing's syndrome. We discuss the case of two patients who present Cushing syndrome due to unilateral adrenal hyperplasia. They presented the signs of clinical hypercorticism as well as metabolic, cardiovascular and osteoporotic complications. Both patients presented clinical and laboratory signs of adrenocorticotropic hormone (ACTH)-independent Cushing syndrome with elevated urinary free cortisol (UFC) levels, adrenal computed tomography (CT) scan revealed the appearance of unilateral adrenal adenoma and normal contralateral adrenal gland. Adrenalectomy was performed under laparoscopic surgery; the resected mass was pathologically diagnosed as unilateral nodular adrenal hyperplasia. Unilateral adrenal hyperplasia is a very rare etiology of ACTH-independent Cushing syndrome, often mistaken for adenoma on CT and only pathological examination can confirm the diagnosis.
A Very Rare Case of Hypereosinophilic Syndrome Secondary to Natural Killer/T-Cell Lymphoma
Authors: Takanori Yamamoto, Atsushi Kamijo, Tadao Nakazawa, Kei Nakajima, Keita Kirito, Norio Komatsu, Keisuke Masuyama
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Hypereosinophilic syndrome (HES) is a systemic disease characterized by an increased peripheral blood eosinophil count accompanied by systemic organ dysfunction. HES is classified into idiopathic HES, primary (neoplastic) HES (HESN), and secondary (reactive) HES (HESR). In this case report, a patient who developed peripheral blood eosinophilia and granulation tissue in the pharynx and paranasal sinus, which was initially diagnosed as chronic eosinophilic leukemia (CEL), categorized as HESN, but was eventually identified after the patient had died as natural killer/T-cell (NK/T) lymphoma, nasal type (ENKL), categorized as HESR, is presented. ENKL-induced HES is very rare but must be considered.
Low-frequency maternal novel MYH7 mosaicism mutation in recurrent fetal-onset severe left ventricular noncompaction: a case report
Authors: Hiroshi Kawamura, Masamichi Ikawa, Keiichi Hirono, Junya Kimura, Takashi Okuno, Masao Kawatani, Kunihiro Inai, Yukiko Hata, Naoki Nishida, Yoshio Yoshida
Journal: Front Pediatr (2023)
Keywords: case report, left ventricular noncompaction, mosaicism mutation, myosin heavy chain 7, next-generation sequencing
MeSH terms: Case Reports

Background:
Left ventricular noncompaction (LVNC) is a rare inherited cardiomyopathy with a broad phenotypic spectrum. The genotype-phenotype correlations in fetal-onset LVNC have not yet been fully elucidated. In this report, we present the first case of severe fetal-onset LVNC caused by maternal low-frequency somatic mosaicism of the novel myosin heavy chain 7 (MYH7) mutation.
Case presentation:
A 35-year-old pregnant Japanese woman, gravida 4, para 2, with no significant medical or family history of genetic disorders, presented to our hospital. In her previous pregnancy at 33 years of age, she delivered a male neonate at 30 weeks of gestation with cardiogenic hydrops fetalis. Fetal echocardiography confirmed LVNC prenatally. The neonate died shortly after birth. In the current pregnancy, she again delivered a male neonate with cardiogenic hydrops fetalis caused by LVNC at 32 weeks of gestation. The neonate died shortly after birth. Genetic screening of cardiac disorder-related genes by next-generation sequencing (NGS) was performed which revealed a novel heterozygous missense MYH7 variant, NM_000257.3: c.2729A > T, p.Lys910Ile. After targeted and deep sequencing by NGS, the same MYH7 variant (NM_000257.3: c.2729A > T, p.Lys910Ile) was detected in 6% of the variant allele fraction in the maternal sequence but not in the paternal sequence. The MYH7 variant was not detected by conventional direct sequencing (Sanger sequencing) in either parent.
Conclusions:
This case demonstrates that maternal low-frequency somatic mosaicism of an MYH7 mutation can cause fetal-onset severe LVNC in the offspring. To differentiate hereditary MYH7 mutations from de novo MYH7 mutations, parental targeted and deep sequencing by NGS should be considered in addition to Sanger sequencing.
An Unusual Cause of Lateral Knee Pain following Total Knee Replacement
Authors: Lynne Barr, Vikas Khanduja, Julian Owen
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

A 70-year-old male underwent elective total knee replacement for osteoarthritis. At initial review six weeks after surgery the prosthesis was functioning well and he was asymptomatic. He reattended clinic four months postoperatively having developed worsening pain on the lateral aspect of the knee but without any loss of function or stiffness of the joint. He subsequently underwent arthroscopy where synovial folds in the lateral gutter were debrided and entirely alleviated his symptoms. This is an unusual cause of pain following total knee replacement which has not been previously reported.
Bayesian Estimation of Small Effects in Exercise and Sports Science
Authors: Kerrie L Mengersen, Christopher C Drovandi, Christian P Robert, David B Pyne, Christopher J Gore
Journal: PLoS One (2016)
MeSH terms: Exercise / physiology, Models, Biological, Sports / physiology, Bayes Theorem, Humans, Sports Medicine

The aim of this paper is to provide a Bayesian formulation of the so-called magnitude-based inference approach to quantifying and interpreting effects, and in a case study example provide accurate probabilistic statements that correspond to the intended magnitude-based inferences. The model is described in the context of a published small-scale athlete study which employed a magnitude-based inference approach to compare the effect of two altitude training regimens (live high-train low (LHTL), and intermittent hypoxic exposure (IHE)) on running performance and blood measurements of elite triathletes. The posterior distributions, and corresponding point and interval estimates, for the parameters and associated effects and comparisons of interest, were estimated using Markov chain Monte Carlo simulations. The Bayesian analysis was shown to provide more direct probabilistic comparisons of treatments and able to identify small effects of interest. The approach avoided asymptotic assumptions and overcame issues such as multiple testing. Bayesian analysis of unscaled effects showed a probability of 0.96 that LHTL yields a substantially greater increase in hemoglobin mass than IHE, a 0.93 probability of a substantially greater improvement in running economy and a greater than 0.96 probability that both IHE and LHTL yield a substantially greater improvement in maximum blood lactate concentration compared to a Placebo. The conclusions are consistent with those obtained using a 'magnitude-based inference' approach that has been promoted in the field. The paper demonstrates that a fully Bayesian analysis is a simple and effective way of analysing small effects, providing a rich set of results that are straightforward to interpret in terms of probabilistic statements.
Case report: Individualized pulsed electromagnetic field therapy in a Long COVID patient using the Adaptive Force as biomarker
Authors: Laura V Schaefer, Frank N Bittmann
Journal: Front Med (Lausanne) (2023)
Keywords: adaptive force, long covid, case report, fatigue, individualized pulsed electromagnetic field, muscle weakness, muscular holding capacity, post-covid syndrome
MeSH terms: Case Reports

The increasing prevalence of Long COVID is an imminent public health disaster, and established approaches have not provided adequate diagnostics or treatments. Recently, anesthetic blockade of the stellate ganglion was reported to improve Long COVID symptoms in a small case series, purportedly by "rebooting" the autonomic nervous system. Here, we present a novel diagnostic approach based on the Adaptive Force (AF), and report sustained positive outcome for one severely affected Long COVID patient using individualized pulsed electromagnetic field (PEMF) at the area C7/T1. AF reflects the capacity of the neuromuscular system to adapt adequately to external forces in an isometric holding manner. In case, maximal isometric AF (AFisomax) is exceeded, the muscle merges into eccentric muscle action. Thereby, the force usually increases further until maximal AF (AFmax) is reached. In case adaptation is optimal, AFisomax is ~99-100% of AFmax. This holding capacity (AFisomax) was found to be vulnerable to disruption by unpleasant stimulus and, hence, was regarded as functional parameter. AF was assessed by an objectified manual muscle test using a handheld device. Prior to treatment, AFisomax was considerably lower than AFmax for hip flexors (62 N = ~28% AFmax) and elbow flexors (71 N = ~44% AFmax); i.e., maximal holding capacity was significantly reduced, indicating dysfunctional motor control. We tested PEMF at C7/T1, identified a frequency that improved neuromuscular function, and applied it for ~15 min. Immediately post-treatment, AFisomax increased to ~210 N (~100% AFmax) at hip and 184 N (~100% AFmax) at elbow. Subjective Long COVID symptoms resolved the following day. At 4 weeks post-treatment, maximal holding capacity was still on a similarly high level as for immediately post-treatment (~100% AFmax) and patient was symptom-free. At 6 months the patient's Long COVID symptoms have not returned. This case report suggests (1) AF could be a promising diagnostic for post-infectious illness, (2) AF can be used to test effective treatments for post-infectious illness, and (3) individualized PEMF may resolve post-infectious symptoms.