OpenMed/multicare-articles huggingface dataset:
Case report: Prone positioning in the improvement of severe post-operative hypoxia following aortic dissection
Authors: Yun Wang, Xuping Cheng, Xuandong Jiang, Lijun Chen
Journal: Front Med (Lausanne) (2024)
Keywords: acute respiratory distress syndrome, aortic dissection, postoperative hypoxia, prone positioning, pulmonary embolism
MeSH terms: Case Reports

Postoperative hypoxemia after aortic dissection surgery presents a considerable clinical challenge, and acute respiratory distress syndrome (ARDS) is a common etiology. Prone positioning treatment has emerged as a potential intervention for improving respiratory function in this context. We report the case of a 27-year-old male who developed severe hypoxemia complicated by pulmonary embolism after aortic dissection surgery. He was diagnosed with postoperative hypoxemia combined with pulmonary embolism following aortic dissection. His respiratory status continued to deteriorate despite receiving standard postoperative care, thereby necessitating an alternative approach. Implementation of prone positioning treatment led to a substantial amelioration in his oxygenation and overall respiratory health, with a consistent hemodynamic state observed throughout the treatment. This technique resulted in significant relief in symptoms and improvement in respiratory parameters, facilitating successful extubation and, ultimately, discharge. This case underlines the possible efficacy of prone positioning therapy in managing severe hypoxia complicated by pulmonary embolism following aortic dissection surgery, warranting more thorough research to explore the potential of this treatment modality.
A Rapidly Enlarging Asymptomatic Parapneumonic Effusion: A Case Report
Authors: Roba El Zibaoui, Yewande E Odeyemi, Mohamad El Labban
Journal: Cureus (2024)
Keywords: asymptomatic pleural effusion, chest tube, community-acquired pneumonia, intrapleural fibrinolytic therapy, parapneumonic effusion, thoracentesis
MeSH terms: Case Reports

A pleural effusion is an accumulation of fluid in the pleural space due to an imbalance between formation and removal. They're commonly caused by heart failure or infections. We report a case of a 56-year-old male with community-acquired pneumonia and a trace pleural effusion on presentation. Despite clinical improvement with antibiotic therapy, the effusion significantly increased on day two. This case report is unique because the patient had an enlarging effusion, but remained asymptomatic and denied worsening shortness of breath, chest pain, or cough. The patient was treated successfully with chest tube placement and intrapleural fibrinolytic therapy. This report emphasizes the importance of repeat imaging for asymptomatic parapneumonic effusions (PPE) that can complicate community-acquired pneumonia. We aim to raise awareness of the atypical presentation and management of parapneumonic effusions through a case report.
Successful salvage of a severe COVID-19 patient previously with lung cancer and radiation pneumonitis by mesenchymal stem cells: a case report and literature review
Authors: Xiaohua Huang, Xin Tan, Xiuwen Xie, Tingshu Jiang, Yang Xiao, Zenghui Liu
Journal: Front Immunol (2024)
Keywords: covid-19, immune modulation, lung cancer, mesenchymal stem cells, severe pneumonia, tissue repairment
MeSH terms: COVID-19 / etiology, Lung Neoplasms / etiology, Mesenchymal Stem Cell Transplantation / adverse effects, Mesenchymal Stem Cells, Radiation Pneumonitis / etiology, Radiation Pneumonitis / therapy, Review, Case Reports, Research Support, Non-U.S. Gov't, Aged, Female, Humans, Neoplasm Recurrence, Local, Pandemics, SARS-CoV-2

During the COVID-19 pandemic, elderly patients with underlying condition, such as tumors, had poor prognoses after progressing to severe pneumonia and often had poor response to standard treatment. Mesenchymal stem cells (MSCs) may be a promising treatment for patients with severe pneumonia, but MSCs are rarely used for patients with carcinoma. Here, we reported a 67-year-old female patient with lung adenocarcinoma who underwent osimertinib and radiotherapy and suffered from radiation pneumonitis. Unfortunately, she contracted COVID-19 and that rapidly progressed to severe pneumonia. She responded poorly to frontline treatment and was in danger. Subsequently, she received a salvage treatment with four doses of MSCs, and her symptoms surprisingly improved quickly. After a lung CT scan that presented with a significantly improved infection, she was discharged eventually. Her primary disease was stable after 6 months of follow-up, and no tumor recurrence or progression was observed. MSCs may be an effective treatment for hyperactive inflammation due to their ability related to immunomodulation and tissue repair. Our case suggests a potential value of MSCs for severe pneumonia that is unresponsive to conventional therapy after a COVID-19 infection. However, unless the situation is urgent, it needs to be considered with caution for patients with tumors. The safety in tumor patients still needs to be observed.
Recurrent Syncope Unveiling Pulmonary Hypertension Secondary to Pulmonary Artery Thrombi in a Pediatric Patient
Authors: Dina AlkhateebAltamimi, Karim Khalidi, Rima Khasawneh, Abdulhadi Alzaben, Khaled Salaymeh
Journal: Cureus (2024)
Keywords: anti-phospholipid antibodies, anti-phospholipid syndrome, pulmonary artery thrombosis, pulmonary emboli, pulmonary hypertension
MeSH terms: Case Reports

We present a case of a nine-year-old female patient who presented with recurrent syncope and was ultimately diagnosed with pulmonary hypertension (PH) secondary to pulmonary artery thrombi in the context of anti-phospholipid syndrome (APS). Extensive investigations including imaging studies revealed PH. Thromboembolic workup confirmed multiple pulmonary artery thrombi, and anti-phospholipid antibody testing confirmed APS. The patient received anticoagulation therapy tailored to APS management. Follow-up assessments demonstrated significant improvement in PH leading to cessation of syncope episodes. In this case, we underscore the importance of considering rare causes of syncope in the pediatric age group, particularly autoimmune disorders. Timely recognition and appropriate management are crucial for favorable outcomes in such cases. This report contributes to understanding the diverse clinical presentations of APS and emphasizes the need for a comprehensive diagnostic approach in patients with unexplained syncope.
A novel termination site in a case of Stüve-Wiedemann syndrome: case report and review of literature
Authors: Deepali Bhalla, Sunil Sati, Donald Basel, Vijender Karody
Journal: Front Pediatr (2024)
Keywords: jak/stat pathway, schwartz–jampel syndrome type 2, stüve–wiedemann syndrome, dysautonomia, leukemia inhibitory factor receptor, neonatal mortality, neonatal respiratory distress, skeletal dysplasia
MeSH terms: Case Reports

Stüve-Wiedemann syndrome (SWS) is a rare autosomal recessive disorder that is characterized by bowing of long bones, dysautonomia, temperature dysregulation, swallowing and feeding difficulties, and frequent respiratory infections. Respiratory distress and hyperthermic events are the leading causes of early neonatal death, and most patients are not expected to survive past infancy. Here, we report on the survival of a 5-year-old male with SWS, discussing his case presentation, providing a brief clinical course, and discussing the outcome. This case adds to the literature surrounding rare instances of childhood survivors of SWS and raises awareness for this syndrome to facilitate an earlier recognition, intervention, and genetic counseling for the families, thereby improving understanding of this disease and the health outcomes for the children affected by this condition.
Chondroma in the Urinary Bladder: An Extremely Rare Finding
Authors: Joao G Porto, Ruben Blachman-Braun, Archan Khandekar, Oleksandr N Kryvenko, Dipen J Parekh
Journal: Case Rep Urol (2024)
MeSH terms: Case Reports

Chondroma, commonly observed in the bones, has limited documentation when found in soft tissues. To date, only 8 chondromas in the urinary bladder have been reported, all in females. Here, we describe a 54-year-old female who presented with a chondroma located at the anterior wall of the urinary bladder. An incidental 5 mm enhanced focus was identified on the right bladder wall during a contrast-enhanced computerized tomography (CT). Subsequent cystoscopy did not reveal any abnormalities, and both urinalysis and urine cytology were unremarkable. However, a CT urogram reconfirmed suspicions of malignancy, which a cystoscopy validated. The patient underwent a transurethral resection of the bladder tumor, which was identified as a bladder chondroma. During the surgical incision, a submucosal lesion was found, which was further confirmed with histopathological evaluation. Over a year-long follow-up using imaging and urine cytology, no recurrence was observed. This case reinforces earlier findings and underscores the predilection for females between their 5th and 7th decades with a positive prognosis.
Case report: VEXAS as an example of autoinflammatory syndrome in pulmonology clinical practice
Authors: Ewa Więsik-Szewczyk, Arkadiusz Zegadło, Agnieszka Sobczyńska-Tomaszewska, Marcelina Korzeniowska, Karina Jahnz-Rózyk
Journal: Front Med (Lausanne) (2024)
Keywords: uba1, autoinflammation, mosaicism, respiratory manifestations, somatic mutations
MeSH terms: Case Reports

Lung involvement is not widely recognized as a complication of auto-inflammatory diseases. We present a broad approach to diagnose a severe form of autoinflammatory syndrome in an adult male patient. A 63-year-old Caucasian male presented with recurrent episodes of high fever, interstitial lung infiltration, and pleural effusion. Laboratory tests performed during the flares revealed lymphopenia and increased levels of C-reactive protein and ferritin. Broad diagnostic research on infections, connective tissue diseases, and malignancies yielded negative results. The patient's symptoms promptly resolved upon the administration of glucocorticoids; however, they reappeared when the prednisone dose was reduced. All attempts to administer immunomodulatory and immunosuppressive medications were ineffective. During follow-up, autoinflammatory syndrome was suspected; however, no pathological variants of monogenic autoinflammatory diseases were identified by genome-exome sequencing. The patient did not respond to interleukin 1 blockade with anakinra. He died due to multi-organ failure, and his condition remained unresolved until the first reported description of vacuole, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome (VEXAS). We describe the diagnostic traps and reasoning process involved in establishing that the patient's symptoms were autoinflammatory in nature based on clinical symptoms, in addition to the proof of concept gained from genetic reevaluation and identification of pathogenic variants in the UBA1 gene. The aim of this review is to increase the awareness of VEXAS among pulmonologists. Genetic screening for UBA1 should be considered in patients with recurrent pneumonitis of unknown origin with elevated inflammatory markers and signs of cytopenia, especially if they require chronic steroids to control the disease. Respiratory manifestations are part of VEXAS; these may be dominant in the course of the disease and severe at presentation.
A brief treatment for veterans with PTSD: an open-label case-series study
Authors: Merel Kindt, Marieke Soeter
Journal: Front Psychiatry (2023)
Keywords: ptsd, imagery rescripting, reconsolidation, trauma memory, treatment, veterans

Introduction:
Despite the positive outcomes observed in numerous individuals undergoing trauma-focused psychotherapy for PTSD, veterans with this condition experience notably diminished advantages from such therapeutic interventions in comparison to non-military populations.
Methods:
In a preliminary study we investigated the efficacy of an innovative treatment approach in a small sample of veterans (n = 7). Recognizing that accessing and targeting trauma memory in veterans with PTSD may be more challenging compared to other patient populations, we employed unique and personalized retrieval cues that engaged multiple senses and were connected to the context of their trauma. This was followed by a session focused on memory reconsolidation, which incorporated both psychological techniques (i.e., imagery rescripting) and a pharmacological component (i.e., 40 mg of propranolol).
Results:
The findings from this small-scale case series cautiously indicate that this brief intervention, typically consisting of only one or two treatment sessions, shows promise in producing significant effects on symptoms of PTSD, distress and quality of life.This is particularly noteworthy given the complex symptomatology experienced by the veterans in this study.
Conclusion:
To summarize, there are grounds for optimism regarding this brief treatment of combat-related PTSD. It appears that the potential for positive outcomes is far greater than commonly believed, as demonstrated by the encouraging results of this pilot study.
Hybrid surgery management challenges of a Behcet's disease patient with recurrence of aortic aneurysms: a case report
Authors: Guo Xin Chen, Jiang Hong Wan, Chu Wen Chen, Bin Huang
Journal: Front Cardiovasc Med (2023)
Keywords: behcet’s disease, bypass, endovascular aneurysm repair, hybrid surgery, open surgery repair, recurrent aneurysms, revascularization
MeSH terms: Case Reports

Background:
Behcet's disease is a vasculitis of unknown origin that can involve multiple organs or tissues. Aneurysm or pseudoaneurysm, also one of the complications of Behcet's disease, is usually accompanied by a poor prognosis. Surgery is usually accompanied by a high risk of complications, such as the recurrence of anastomotic pseudoaneurysms and blockage of the target vessel. Using hybrid surgery, we successfully treated a complex and recurrent abdominal aortic pseudoaneurysm in a patient with BD.
Methods:
We report a 32-year-old female diagnosed with Behcet's disease with recurrent thoracoabdominal aortic aneurysm. Adequate immunotherapy was given during the perioperative period. The splanchnic artery branches were reconstructed, and the aneurysm was sequestered with endovascular repair. The patient recovered uneventfully and was discharged from the hospital 8 days after hybrid surgery. At the 60-month follow-up, no aneurysm was observed, the stent had no displacement or internal leakage, and the reconstructed blood vessels were unobstructed.
Conclusion:
Hybrid surgery could be a feasible and effective strategy for BD aneurysms. Adequate preoperative and postoperative immunotherapy with arterial anastomosis away from the diseased artery may be the key to success.
Case report: Long-term survival in puppies assessed with echocardiography, electrocardiography and cardiac troponin I after acute death in littermates due to parvoviral myocarditis
Authors: Brenda Dines, Heidi Kellihan, Carolyn Allen, Alan Loynachan, Philip Bochsler, Sandra Newbury
Journal: Front Vet Sci (2023)
Keywords: cpv-2, myocarditis, parvo, parvovirus, prognosis, puppy, survival, troponin (ctni)
MeSH terms: Case Reports

Positive clinical outcomes of a group of surviving puppies from a litter affected by parvoviral myocarditis are detailed in this case report. Past reports focus on the negative outcomes of littermates of puppies who have died of parvoviral myocarditis. In this case, two puppies in a shelter setting, from a litter exposed to parvovirus, died suddenly with parvoviral myocarditis diagnosed at necropsy. The other seven puppies were screened for cardiac health with echocardiogram, electrocardiogram, and cardiac troponin I prior to adoption. All seven puppies had normal echocardiograms, electrocardiograms, and normal initial and recheck cardiac troponin I results. At recheck 2 years after the initial round of testing, two of the puppies were screened and continue to have normal cardiac diagnostics. All seven dogs are alive and thriving at 5 years old in homes with adopters who were given a complete medical history on the dogs prior to adoption. In summary, the outcomes for puppies in litters affected by parvoviral myocarditis are variable but they do not have to be grave. The use of cardiac diagnostics including echocardiogram, electrocardiogram and cardiac troponin I may serve as a prognostic basis for assessing the potential outcomes for the surviving puppies in affected litters.
A Rare Case of Internal Jugular Venous Malformation Treated by Surgical Excision
Authors: Rishik Puppala, Bright Benfor, Shri Timbalia, Tiffany G Sheu, Alan B Lumsden
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: ijv, ijvm, internal jugular vein, internal jugular venous malformation, vascular malformation, venous malformation
MeSH terms: Jugular Veins / abnormalities, Jugular Veins / diagnostic imaging, Jugular Veins / surgery, Vascular Malformations / complications, Vascular Malformations / diagnostic imaging, Vascular Malformations / physiopathology, Vascular Malformations / surgery, Case Reports, Adult, Female, Humans, Ligation, Male, Phlebography, Treatment Outcome, Vascular Surgical Procedures

This paper reports a case of an internal jugular venous malformation (IJVM) and route of treatment in a patient with limited symptoms. After history and imaging studies, a determination of surgical excision was made to rule out possible malignancy and future problems such as thrombosis. The mass was resected, and part of the IJVM was ligated. The mass had no identifiable malignancy, and the patient recovered fully with no complications. The paper highlights the importance of identifying venous malformations and highlights the reasoning behind the course of action.
Neoadjuvant chemoimmunotherapy achieved a pathologic complete response in stage IIIA lung adenocarcinoma harboring RET fusion: a case report
Authors: Minqian Dai, Na Wang, Qin Xia, Yongde Liao, Wei Cao, Jun Fan, Diwei Zhou, Sihua Wang, Xiu Nie
Journal: Front Immunol (2024)
Keywords: ret fusion, lung adenocarcinoma, neoadjuvant chemoimmunotherapy, pathological complete response, stage iiia
MeSH terms: Adenocarcinoma of Lung / genetics, Adenocarcinoma of Lung / therapy, Carcinoma, Non-Small-Cell Lung / drug therapy, Carcinoma, Non-Small-Cell Lung / genetics, Lung Neoplasms / drug therapy, Lung Neoplasms / genetics, Case Reports, Research Support, Non-U.S. Gov't, Humans, Neoadjuvant Therapy, Pathologic Complete Response, Proto-Oncogene Proteins c-ret / genetics, RET protein, human, Proto-Oncogene Proteins c-ret

Neoadjuvant chemoimmunotherapy has demonstrated significant benefit for resectable non-small-cell lung cancer (NSCLC) excluding known EGFR/ALK genetic alterations. Recent evidence has shown that neoadjuvant chemoimmunotherapy could be clinically valuable in resectable localized driver gene-mutant NSCLC, though the data still lack robust support, especially for rare oncogenic mutations. Here, we report a patient with stage IIIA lung adenocarcinoma with a RET fusion gene and high expression of PD-L1 who underwent neoadjuvant chemoimmunotherapy and successfully attained a pathologic complete response. The patient has survived for 12 months with no recurrence or metastases after surgery. Our case suggests that this treatment strategy may be an alternative therapeutic option for resectable RET fusion-positive NSCLC patients.
Case report: outcome of anlotinib treatment in breast cancer patient with brain metastases
Authors: Qiongwen Zhang, Xi Yan, Ting-Lun Tian, Xin Wu
Journal: Front Pharmacol (2024)
Keywords: anlotinib, brain metastases, breast cancer, case report, chemothearpy
MeSH terms: Case Reports

Brain metastases (BM) represent a common and severe complication of breast cancer (BC), emerging in approximately 10%-16% of all BC patients. The prevalent approach for treating BC patients with BM encompasses a multimodal strategy, combining surgery, whole brain radiation therapy, and stereotactic radiosurgery. Yet, a concrete guideline for localized treatment strategies remains elusive, while systemic treatments like small-molecule-targeted therapy and immunotherapy are still in the clinical trial phase. This case study presents a significant clinical response to anlotinib treatment in a patient with estrogen receptor-negative, progesterone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-positive breast cancer, complicated by BM. After the standard first-line treatment including albumin-bound paclitaxel, trastuzumab and pertuzumab, and a second-line treatment involving pyrotinib, capecitabine, and radiotherapy did not produce the desired results, the patient was then administered anlotinib in combination with pyrotinib and letrozole as a third-line treatment, which led to a partial response (PR). The findings suggest that anti-angiogenic therapy, specifically anlotinib, could be regarded as a promising therapeutic option for BC patients with BM.
Digenic Origin of Difference of Sex Development in a Patient Harbouring DHX37 and MAMLD1 Variants
Authors: Katia Margiotti, Francesco Libotte, Marco Fabiani, Alvaro Mesoraca, Claudio Giorlandino
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Background:
The diagnostic process for identifying variations in sex development (DSD) remains challenging due to the limited availability of evidence pertaining to the association between phenotype and genotype. DSD incidence is reported as 2 in 10,000 births, and the etiology has been attributed to genetic causes. Case Presentation. The present study investigated genetic causes implicated in a case of a 15-year-old 46, XY patient, raised as a girl. Genetic analysis by clinical exome sequencing (CES) showed a digenic inheritance due to two known pathogenic mutations in the DHX37 gene and the MAMLD1 gene, while we excluded variants with pathogenic significance in 209 DSD-related genes.
Conclusions:
Based on our literature review, this is the first case with the combined presence of pathogenic mutations in the MAMLD1 gene and DHX37 gene in a patient with gonadal dysgenesis.