OpenMed/multicare-articles huggingface dataset:
First reported cases: renal denervation with second-generation multi-electrode catheter via brachial and radial access
Authors: M J Heradien, J Augustyn, A Saaiman, P A Brink
Journal: Cardiovasc J Afr (2016)
MeSH terms: Blood Pressure / physiology, Catheters, Electrodes, Heart Conduction System / surgery, Kidney / surgery, Case Reports, Catheter Ablation / methods, Female, Heart Conduction System / physiopathology, Humans, Hypertension / physiopathology, Middle Aged, Sympathectomy / methods

Renal denervation is a minimally invasive procedure that aims to reduce brain-kidney sympathetic cross-talk. Despite the negative results of the recent SYMPLICITY HTN-3 trial, the procedure is considered safe and has been associated with many beneficial effects, including the reversal of hypertensive heart disease substrate and the prevention of cardiac arrhythmia. The first-generation radiofrequency catheter system featured a monopolar catheter that required sequential singlepoint energy application, followed by rotation, partial withdrawal of the catheter and re-application of energy. The latest generation device features four electrodes configured in a helical arrangement that can simultaneously ablate in four quadrants of the vessel circumference. Renal denervation via brachial or radial arterial access with the second-generation system has not been described before.
Primary percutaneous coronary intervention for cardio-cerebral infarction: a case report
Authors: Tomomi Watanabe, Satoshi Kobara, Ryosuke Amisaki, Kazuhiro Yamamoto
Journal: Front Cardiovasc Med (2023)
Keywords: acute ischemic stroke, acute myocardial infarction, cardio-cerebral infarction, case report, coronary embolism, primary percutaneous coronary intervention
MeSH terms: Case Reports

Background:
Acute myocardial infarction (AMI) and acute ischemic stroke (AIS) are the leading causes of death globally. Cardio-cerebral infarction (CCI) is the rare occurrence of AMI and AIS, either simultaneously or one after the other. Treatment recommendations are not clear in case of the occurrence of AMI and AIS simultaneously, especially the strategy of primary percutaneous coronary intervention (PCI).
Case presentation:
We report consecutive seven case series of patients with CCI who underwent primary PCI in our institute. Comorbidities, strategy of primary PCI, and outcomes were investigated. All patients presented with the chief complaints associated with stroke. Atrial fibrillation (AF) was complicated in five of CCI patients, and four of AF patients were not anticoagulated. The major causes of stroke were cardiogenic and/or hemodynamic in this case series. All patients showed total occlusion in the culprit lesion, and six patients had other diseased vessels. Thrombus aspiration was mainly chosen as the reperfusion strategy in PCI. However, only two patients were diagnosed as definitive coronary embolism, and stenting was needed in six patients due to severe atherosclerotic lesion in culprit coronary artery. Final thrombolysis in myocardial infarction (TIMI) 3 flow was achieved only in four patients. Hemorrhagic complications occurred in three patients. Two patients died during in-hospital stay, and most had to be transferred for rehabilitation.
Conclusions:
CCI was a rare but fatal condition in patients who underwent primary PCI. Although CCI was associated with concomitant atrial fibrillation, organic coronary stenosis requiring stenting for revascularization was present in almost all the cases. Given the complexity of coronary artery lesions and high in-hospital mortality, further investigations are needed to determine the optimal treatment strategy.
Efficacy of Hydroxychloroquine for Improving Pregnancy Outcomes in a Female with Systemic Lupus Erythematosus and Antiphospholipid Syndrome
Authors: Yumika Takaki, Atsushi Daimon, Misa Nunode, Tomohito Tanaka, Daisuke Fujita, Masahide Ohmichi
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

The use of heparin and low-dose aspirin is the current conventional treatment for pregnant females with antiphospholipid syndrome (APS). However, there is no additional treatment recommended for cases where the standard treatment cannot prevent obstetric complications such as fetal loss and placental insufficiency. Recently, the addition of a novel antimalarial, hydroxychloroquine (HCQ), to the conventional treatment has shown the potential to prevent obstetric complications. Herein, we report a case in which the addition of HCQ improved adverse pregnancy outcomes in a pregnant female with systemic lupus erythematosus and aspirin-heparin-resistant APS.
Extreme Short Stature and Severe Neurological Impairment in a 17-Year-Old Male With Untreated Combined Pituitary Hormone Deficiency Due to POU1F1 Mutation
Authors: Hussein Majdoub, Serge Amselem, Marie Legendre, Shoshana Rath, Dani Bercovich, Yardena Tenenbaum-Rakover
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: ch, gh deficiency, ghd, pou1f1 gene, central hypothyroidism, congenital hypothyroidism
MeSH terms: Case Reports

Background: POU1F1 is an essential transcription factor for the differentiation, proliferation and survival of somatotrophs, lactotrophs, and thyrotrophs. Mutations in the POU1F1 gene are characterized by growth hormone (GH), thyrotropin, and prolactin deficiencies, commonly presenting with growth retardation and central hypothyroidism. Since the first report in 1992, more than 25 mutations have been identified in POU1F1. Case Description: We describe a 17-year-old male who presented to our Pediatric Endocrinology clinic with extreme short stature (height 81.7 cm, -9.3 SD), cognitive impairment, deaf-mutism, and neurological disabilities. L-thyroxine supplemental therapy, which had been initiated at the age of 6 months but ceased due to non-compliance, was reintroduced at presentation. GH therapy was initiated at 19 years of age, resulting in 42 cm linear growth, to a final height of 124 cm. Sequencing of POU1F1 revealed a previously described homozygous insertion mutation-c.580_581insT, p (Thr194Ilefs*7)-in exon 4 causing a frameshift that introduces a stop codon 7 amino acids downstream, leading to a severely truncated protein lacking the homeodomain. Conclusion: This case report sheds light on the natural history of untreated patients with POU1F1 mutations and raises awareness for early diagnosis and adequate treatment of central congenital hypothyroidism and GH deficiency.
Endoscopic removal of a retained surgical sponge in a young Syrian refugee after Caesarean section: a case report with discussion of cultural and political consequences
Authors: Johannes Ackermann, Moritz Kanzow, Micaela Mathiak, Ulrich Pecks, Nicolai Maass, Ibrahim Alkatout
Journal: Patient Saf Surg (2016)
Keywords: complications, diagnostics, language barrier, laparoscopy, refugee, retained instrument, retained sponge, safety strategies
MeSH terms: Case Reports

Background:
Inadvertently retained sponges and instruments still constitute a major but preventable complication in surgery. Given the high geographic mobility of patients, the fluctuation of physician-patient contact, and communication problems due to language barriers, the conscientious use of structured safety protocols in clinical routine is an essential aspect of quality in health care.
Case presentation:
We report the case of a 24-year-old refugee from Syria who presented at our gynecological outpatient department with a tumor in the lower abdomen, suspected to be a lump in the ovary or the uterus. Language barriers hindered exact recording of the patient's medical history. We knew she had undergone three Caesarean sections several years ago. The diagnostic laparoscopy unexpectedly revealed a tumor suspected to be a retained surgical sponge. The lesion was removed completely and the patient discharged from the clinic five days later.
Conclusion:
In ambiguous cases, the diagnostic and therapeutic potential of minimally invasive surgery ensures safe and effective treatment of the patient, a short hospital stay, and low rates of complications. Especially in cases of language and/or cultural barriers, structured safety protocols should be a part of clinical routine in order to prevent unnecessary complications.
A case of morning glory syndrome associated with persistent hyperplastic primary vitreous and Peters' anomaly
Authors: Isil Sayman Muslubas, Mumin Hocaoglu, Serra Arf, Murat Karacorlu
Journal: GMS Ophthalmol Cases (2017)
Keywords: peters’ anomaly, doppler ultrasonography, morning glory syndrome, persistent hyperplastic primary vitreous
MeSH terms: Case Reports

We report a case of morning glory syndrome (MGS) associated with persistent hyperplastic primary vitreous (PHPV) and Peters' anomaly. A 2-day-old girl, born at term with a birth weight of 3,350 g was diagnosed with Peters' anomaly, cataract, microphthalmia, PHPV, and MGS. A right limbal lensectomy and vitrectomy with stalk cauterization was performed 8 days later. No early postoperative complication occurred, the family was discharged with advice on medication, and follow-up examination was scheduled. The case report reveals the coexistence of PHPV, Peters' anomaly, and MGS, which may suggest a genetic link.
Wanting to Forget: Intrusive and Delusional Memories from Critical Illness
Authors: Lauren Doig, Kevin Solverson
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Introduction. Delusional and fearful memories after critical illness are observed in up to 70% of patients post critical illness. However, they often go unrecognized after patients leave the intensive care unit (ICU). Case Presentation. A 40-year-old male was admitted to the ICU with community-acquired pneumonia and multiorgan failure requiring mechanical ventilation and renal replacement therapy. He developed protracted delirium and severe ICU-acquired weakness but was eventually discharged home. The patient returned to a follow-up clinic two months post-ICU discharge and revealed that he was suffering anxiety from memories in the ICU of different staff trying to harm and kill him, including being repeatedly suffocated. By providing context to the memories, the patient had significant relief in his anxiety. Conclusions. Intrusive memories contribute to psychological morbidity post critical illness, including posttraumatic stress disorder (PTSD) and reduced health-related quality of life. The majority of critical illness survivors do not share their intrusive or frightening memories, and therefore, most healthcare professionals are unaware of the problems they can pose. Assessment of patients' memories from the ICU is essential and may create the opportunity to help patients place memories into context and improve psychological morbidities.
Digital Ischemia as an Unusual Manifestation of Hodgkin's Lymphoma
Authors: Fiorella Villano, Adriana Peixoto, Eloísa Riva, Carina Di Matteo, Lilián Díaz
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Digital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud's syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hematological malignancies. We report the case of a 45-year-old male, smoker, with a 10-day history of pain, cyanosis, and progressive digital necrosis in both hands. In the previous four months, he noticed painless mass in the right axillary gap, drenching night sweats, and weight loss. Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs), enlarged lymph nodes in right axillary, and right supraclavicular gaps. Arteriography of upper limbs demonstrated a distal stop in all bilateral digital arteries. Digital ischemia was interpreted as a paraneoplastic phenomenon after other common etiologies were ruled out. Amputation of three phalanges was required due to necrosis. Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin's lymphoma (HL). The patient started conventional ABVD protocol (doxorubicin, bleomycin, vinblastine, and dacarbazine). After 6 cycles, he remained asymptomatic and symptoms of digital ischemia were completely resolved. It was concluded that the presence of acral vascular syndromes should alert the physician about the possibility of underlying malignant disease. Prompt investigation and treatment should be rapidly performed to avoid digital sequelae.
A Ruptured Ectopic Pregnancy Presenting with a Negative Urine Pregnancy Test
Authors: Johnathan Michael Sheele, Rachel Bernstein, Francis L Counselman
Journal: Case Rep Emerg Med (2016)
MeSH terms: Case Reports

A negative urine pregnancy test in the emergency department traditionally excludes the diagnosis of pregnancy. We report a rare case of ruptured ectopic pregnancy in a patient with a negative urine pregnancy test but with a serum beta-human chorionic gonadotropin (β-hCG) of 10 mIU/mL. The patient developed hemoperitoneum and required laparoscopy by Obstetrics and Gynecology (OB/Gyn). This case highlights the fallibility of the urine pregnancy test in diagnosing early pregnancy.
Calcific Tendinitis of the Supraspinatus Tendon in an Infant
Authors: Masanori Wako, Jiro Ichikawa, Kensuke Koyama, Yoshihiro Takayama, Hirotaka Haro
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Calcific tendinitis of the supraspinatus tendon in adults is common, but it is extremely rare in children. This report presents an unusual case of a 2-year-old boy with calcific tendinitis of the supraspinatus tendon. A mother brought her 2-year-old son to our hospital with a fever and severe left shoulder pain. Examination revealed a temperature of 38.6°C accompanied by a swollen shoulder with extreme pain and restricted movement. The radiographs of his left shoulder showed a large radio-opacity in the subacrominal region, and magnetic resonance imaging showed an elongated T1 and T2 hypointense signal above the supraspinatus tendon. Although these images were suggestive of calcific tendinitis of the supraspinatus tendon, we performed an open biopsy and resection in order to differentiate between a suspected diagnosis of calcific tendinitis, which is incredibly rare within pediatric patients, and infection or a soft tissue tumor. Finally, calcific tendinitis of the supraspinatus tendon was diagnosed by pathologic experiment and successfully treated, with complete resolution of pain and movement. Because only four other pediatric cases of calcific tendinitis of the supraspinatus tendon have ever been reported, there is a lack of information on the diagnostic process, management, and treatment of such a condition in young patients. Calcific tendinitis of the supraspinatus tendon still should be considered when encountering cases with typical findings even if the patient is a child.
Clinical Characteristics of Children with COVID-19
Authors: Carmen Lok Tung Ho, Peter Oligbu, Olakunle Ojubolamo, Muhammad Pervaiz, Godwin Oligbu
Journal: AIMS Public Health (2020)
Keywords: 2019-ncov, covid-19, sars-cov-2, children, coronavirus, infectious disease, paediatric, pandemic, severe acute respiratory syndrome coronavirus 2, virus
MeSH terms: Review

Background:
In December 2019, the infection caused by 2019 novel coronavirus (COVID-19) led to an outbreak in Wuhan, situated in the Hubei Province of China. Following this, there has been a rapid increase in the number of cases. On 12th March 2020, there were over 100,000 confirmed cases and almost 4,300 deaths worldwide. The clinical profile of children with COVID-19 is unknown due to the few number of cases reported. Currently, available data suggest they may have a milder form of illness.
Methods:
A review of the literature published from June 2019 to March 2020 was undertaken to evaluate the clinical presentation, management and outcomes of COVID-19 in in children. Data sources included EMBASE, MEDLINE, Cochrane library, ISI Web of Knowledge and references within identified articles.
Results:
We identified 303 potential studies, and 295 were excluded for reasons including duplicates, experimental studies and case reports. Eight studies were eligible for inclusion, including a total of 820 paediatric cases of COVID-19. Asymptomatic cases represented 14.3% (n = 117) of the total number of cases identified, and thus the remaining 85.7% (n = 703) experienced symptoms. Fever was the commonest symptom in 53.9% (n = 48) of cases, followed by cough in 39.3% (n = 35) of cases, and rhinorrhoea or pharyngeal congestion in 13.5% (n = 12) of cases. Diarrhoea and sore throats were less common symptoms, 7.9% (n = 7) and 9.0% (n = 8) respectively. Other symptoms, including fatigue, headache and dizziness were rare.
Conclusion:
Children are disproportionately affected by COVID-19 and are more likely to run a milder cause of illness following this infection compared to adults. This outbreak only started 3 months ago, therefore, further population wide studies are needed to validate these findings.
Arthroscopic removal of loose bodies in synovial chondromatosis of shoulder joint, unusual location of rare disease: A case report and literature review
Authors: Hussain Wahab, Obada Hasan, Ahmed Habib, Naveed Baloch
Journal: Ann Med Surg (Lond) (2018)
Keywords: arthroscopic synovectomy, loose bodies, shoulder arthroscopy, synovial chondromatosis
MeSH terms: Case Reports

Introduction:
Synovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery.
Case presentation:
20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years and decreased range of motion. There was no history of trauma or fever. Work up done and diagnosed with synovial chondromatosis. Arthroscopic removal of chondromatoid loose bodies and synovectomy was done. More than 120 loose bodies were removed. On two (2) years follow-up patient is pain free and having full range of motion at right shoulder joint.
Discussion:
Synovial chondromatosis is rare in shoulder joint. The Primary synovial chondromatosis of unknown etiology, and secondary synovial chondromatosis due to degenerative joint disease. Classic treatment is arthrotomy and synovectomy. With recent advances, arthroscopic removal of loose bodies and synovectomy is also a good option for its treatment. In literature only few cases have been reported treated with arthroscopic removal of loose bodies and synovectomy.
Conclusion:
Arthroscopic treatment of synovial chondromatosis is a good option if expertise is available. It causes less surgical trauma, better visualization during surgery, early recovery.
A case management of hypertension in the elderly in sub-Sahara Africa: lessons from Granny
Authors: Ahmadou Musa Jingi, Liliane Mfeukeu Kuate, Jean Jacques Noubiap
Journal: Pan Afr Med J (2017)
Keywords: hypertension, elderly, management, side effects, sub-saharan africa
MeSH terms: Angiotensin-Converting Enzyme Inhibitors / therapeutic use, Hypertension / drug therapy, Polypharmacy, Case Reports, Africa South of the Sahara, Age Factors, Aged, Angiotensin-Converting Enzyme Inhibitors / administration & dosage, Angiotensin-Converting Enzyme Inhibitors / adverse effects, Drug Interactions, Female, Humans, Angiotensin-Converting Enzyme Inhibitors

Management of chronic disease conditions in the elderly is challenging. They usually have many co-morbidities requiring multiple drug regimens, and memory or cognitive problems that can interfere with management. Also, they sometimes have a degree of social problems as they might often live alone, and thereby cater for their daily activities with minimal assistance. Multiple drug use combined with their fragile health predispose them to adverse drug reactions, drug-drug interactions, and direct drug toxicity from overdosing. We report and discuss the lessons learnt from the case of an elderly woman in an urban setting in sub-Saharan Africa who presented with problems of drug dosing, adverse drug effect, and drug-drug interaction that might prove useful in the future management of hypertension with angiotensin converting enzyme inhibitors.
Simultaneous treatment for M ycobacterium-avium complex lung disease and allergic bronchopulmonary aspergillosis: A case report
Authors: Nobuhiro Oda, Kei Nakashima, Yuya Homma, Norihiko Kubota, Jumpei Taniguchi, Tatsuya Nagai, Yoshinori Yoshimi, Ayumu Otsuki, Hiroyuki Ito
Journal: Respir Med Case Rep (2021)
Keywords: allergic bronchopulmonary aspergillosis, mycobacterium-avium complex, therapy
MeSH terms: Case Reports

Recently, there are several reports of simultaneous allergic bronchopulmonary aspergillosis (ABPA) and Mycobacterium-avium complex (MAC) lung disease. However, the strategies for early diagnosis and appropriate treatment for patients with both ABPA and MAC lung disease have not been established. Here, we report a case with ABPA complicated by MAC lung disease, which was successfully diagnosed and treated by simultaneous administration of systemic steroids and antimycobacterial drugs. Bronchoscopy can be useful in the diagnosis of such cases. Furthermore, in a patient with concurrent ABPA and MAC lung disease, simultaneous treatments for both diseases could reduce both diseases.
Monostotic fibrous dysplasia involving occipital bone: a case report and review of literature
Authors: Recep Basaran, Mustafa Kaksi, Erdal Gur, Mustafa Efendioglu, Ece Balkuv, Aydin Sav
Journal: Pan Afr Med J (2014)
Keywords: fibrous dysplasia, cranial, cystic, monostotic, occipital, trauma
MeSH terms: Fibrous Dysplasia, Monostotic / pathology, Magnetic Resonance Imaging, Occipital Bone / pathology, Case Reports, Review, Adolescent, Diagnosis, Differential, Disease Progression, Female, Fibrous Dysplasia, Monostotic / diagnosis, Fibrous Dysplasia, Monostotic / surgery, Humans, Tomography, X-Ray Computed

Fibrous dysplasia (FD) is a progressive systemic bone tumour of young and it can be seen on cranial bones. FD is divided into three types according to radiological features. The second most common subtype is polyostotic subtype. With this article, we aimed to review and present clinical features, radiological examination, differential diagnosis and treatment management of a case of solitary monostotic fibrous dysplasia of occipital bone. 15 years old female patient admitted to our hospital for a bump and in the back of his head that she noticed 1 month ago. Her physical and neurological examination was normal. On cranial CT examination we detected a bony defect. Her gadolinium enhanced cranial MRI revealed bony defect along with massive gadolinium enhancement in adjacent tissue. On histopathologic examination; PANCK, CD68, CD1a were found negative and CD45, S-100, Vimentine were found positive. Ki-67 was 4,8%. In conclusion, fibrous dysplasia is a progressive bone disease of the young patients. Despite its resemblance to a benign lesion by not being symptomatic it can progress and cause severe bony defects and skin lesions. Total surgical resection is necessary and sufficient for total treatment.