OpenMed/multicare-articles huggingface dataset:
Perforation of the right ventricle induced by pulmonary artery catheter at induction of anesthesia for the surgery for liver transplantation: a case report and reviewed of literature
Authors: Maria Auxiliadora-Martins, Erick Apinagés Dos Santos, Daniel Adans Wenzinger, Gil Cezar Alkmim-Teixeira, Gerardo Cristino de M Neto, Ajith Kumar Sankarankutty, Orlando de Castro E Silva, Olindo Assis Martins-Filho, Anibal Basile-Filho
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We report a case of a 45-year-old male patient diagnosed with liver cirrhosis by hepatitis C and alcohol, with a Child-Pugh score C and a model for end-stage liver disease (MELD) score of 27, and submitted to liver transplantation. The subject underwent insertion of the pulmonary artery catheter (PAC) in the right internal jugular vein, with technical difficulty concerning catheter advance. There was sudden hypotension, increase in central venous pressure (CVP), and decrease in SvO(2) 15 minutes after the PAC had been inserted, followed by cardiorespiratory arrest in pulseless electrical activity (PEA), which was promptly assisted with resuscitation. Pericardiocentesis was performed without success, so the individual was subjected to a subxiphoid pericardial window, which led to output of large amounts of blood as well as PEA reversal to sinus rhythm. Sternotomy was performed; rupture of the apex of the right ventricle (RV) was detected, and suture of the site was accomplished. After hemodynamic stabilization, the patient was transferred to the ICU, where he developed septic shock and, despite adequate therapy, died on the eighteenth day after ICU admission.
Subacute Right Ventricular Perforation by Pacemaker Lead Causing Left-Sided Hemothorax and Epicardial Hematoma
Authors: Abdelrahman Ahmed, Mohamed Shokr, Randy Lieberman
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

We report a case of right ventricular wall perforation by a pacemaker lead in a 78-year-old female 18 days after a permanent pacemaker insertion. This injury necessitated explant of the perforating lead and implantation of a new one with surgical backup. We review the literature and discuss the possible risk and protective factors including lead models that were associated with higher incidence of perforation. We review the traditional pacing parameters and their lack of reliability to diagnose perforation and the need for low threshold to utilize imaging in appropriate clinical scenarios. The authors believe this case is of educational value to all health care professionals, especially emergency medicine and internal medicine residents, who routinely see patients with pacemakers complaining of chest pain, shortness of breath, or dizziness.
Hemophagocytic lymphohistiocytosis and visceral leishmaniasis in children: a series of cases and literature review
Authors: Natália Fernanda Ferreira Brum, Julia Sampaio Coelho, Laís Silva Carvalho, Matheus Nascimento Otoni Vieira, Aline Almeida Bentes, Ericka Viana Machado Carellos, Lilian Martins Oliveira Diniz, Andrea Lucchesi de Carvalho, Roberta Maia de Castro Romanelli
Journal: Rev Paul Pediatr (2021)
MeSH terms: Anemia, Leishmaniasis, Visceral / complications, Leishmaniasis, Visceral / diagnosis, Lymphohistiocytosis, Hemophagocytic / diagnosis, Case Reports, Review, Fever, Humans, Syndrome

Objective:
Hemophagocytic lymphohistiocytosis syndrome (HLHS) is characterized by an immunological hyperactivation of cytotoxic T cells, natural killer cells, and macrophages, leading to the secretion of proinflammatory cytokines. HLHS associated with Visceral Leishmaniasis might be difficult to diagnose once symptoms are similar, resulting in the death of untreated patients. Our aim is to describe a series of cases of Visceral Leishmaniasis with HLHS admitted to a referral hospital for infectious diseases.
Case description:
All 115 cases of Visceral Leishmaniasis referred to a referral center for pediatric infectious diseases were reviewed to identify the cases of HLHS. Five cases (4.5%) were confirmed with HLHS and they presented fever, splenomegaly, cytopenia, hypertriglyceridemia or hypofibrinogenemia, increased ferritin and hemophagocytosis in the bone marrow.
Comments:
It important to rule out HLHS in children with infectious diseases that do not respond adequately to treatment or in patients with severe symptoms, especially in leishmaniasis endemic areas.
Giant lymphatic cyst of omentum: a case report
Authors: Sanjeev Kumar, Nikhil Agrawal, Rahul Khanna, A K Khanna
Journal: Cases J (2009)

Background:
Omental cysts are rare abdominal lesions and are difficult to diagnose. Mostly they are detected incidentally during imaging studies performed for unrelated reasons.
Case presentation:
Presentation can be both acute and chronic. Acute presentations are usually due to complication in cyst. Imaging is helpful in excluding other causes of lump abdomen. We encountered a case of giant lymphatic cyst presenting with abdominal swelling, clinically mimicking huge ovarian cyst.
Conclusion:
The goal of surgical therapy is complete excision of the cyst, and Omental cysts can be removed without endangering the adjacent bowel.
Cicatricial Organizing Pneumonia with Dendriform Pulmonary Ossification: An Unusual Cause for a Recurrent Pneumothorax
Authors: Mnahi Bin Saeedan, Carol Farver, Atul C Mehta, Ruchi Yadav
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Cicatricial organizing pneumonia is an uncommon form of organizing pneumonia, which may manifest as persisting linear opacities on computerized tomography (CT) scan mimicking a fibrosing interstitial pneumonia. It may also manifest with pulmonary ossification, which is a metaplastic bone formation within the lung tissue. The latter presentation could be either nodular or dendriform, both secondary to underlying lung disease and rarely idiopathic. Dendriform pulmonary ossification (DPO) has rarely been described as a cause of spontaneous pneumothorax. We present a case of a 55-year-old male with history of recurrent pneumothoraces and worsening dyspnea on exertion. A CT of the chest revealed progressive bilateral sub-pleural and peribronchovascular reticular opacities associated with densely ossified branching and nodular opacities. Video-assisted thoracoscopic biopsy of the lung demonstrated cicatricial organizing pneumonia with areas of marked diffuse DPO. The case highlights that dendriform pulmonary ossification arising from cicatricial organizing pneumonia should be considered in the differential diagnosis of recurrent pneumonias among patients with lower lobe sub-pleural reticular opacities. The case highlights that dendriform pulmonary ossification rarely can cause spontaneous pneumothorax and can be associated with cicatricial organizing pneumonia and reticular opacities on imaging.
Challenges of Diagnosing Primary Ewing's Sarcoma in the Small Intestine of the Elderly: A Case Report
Authors: Jianchuan Yang, Hong Wei, Yucheng Lin, Ning Lin, Songsong Wu, Xunbin Yu
Journal: Front Oncol (2021)
Keywords: ewing’s sarcoma, elderly, extraosseous ewing’s sarcoma, primitive intestine tumor, ultrasonography
MeSH terms: Case Reports

Extraosseous Ewing's sarcoma (EES) is a malignant tumor that is classified as a rare disease. EES is common in children and adolescents, with a rarer incidence being present in the elderly. ES of the primary intestine is rare, with only a few reports described in the literature. Here we report a case of a 69-year-old male patient who was experiencing abdominal pain for over 3 months. Ultrasonography (US) revealed a solid hypoechoic lesion with multiple irregular necrotic areas in the left lower abdomen close to the dome of the bladder. Contrast-enhanced ultrasonography (CEUS) showed that the lesion exhibited heterogeneous enhancement and quick peripheral enhanced tissue wash-out classifying this mass as malignant. PET-CT showed a high metabolic mass in the lower abdomen, multiple metabolic nodules in the mesentery, considered as a small intestinal stromal tumor with lymph nodes metastasis, and that a diagnosis of lymphoma should be excluded. Esophagogastroduodenoscopy performed at another hospital 1 month prior to CT showed an abnormal density in the pelvic cavity that was considered as a colonic diverticulum with an abscess. The endoscopy showed no obvious occupying lesions. The mass was removed and postoperative pathology confirmed ES of the small intestine. The patient avoided receiving chemotherapy. After 2 months, skull metastasis was diagnosed and surgical intervention was done. His survival was only six months after the second surgery. To our knowledge, our case is the first report of ultrasound and CEUS manifestation of EES in the small intestine in elderly.
Modulations in the Peripheral Immune System of Glioblastoma Patient Is Connected to Therapy and Tumor Progression-A Case Report from the IMMO-GLIO-01 Trial
Authors: Paul F Rühle, Nicole Goerig, Roland Wunderlich, Rainer Fietkau, Udo S Gaipl, Annedore Strnad, Benjamin Frey
Journal: Front Neurol (2017)
Keywords: glioblastoma multiforme, immune status, immunophenotyping, liquid biopsy, personalized medicine, radiochemotherapy
MeSH terms: Case Reports

Immune responses are important for efficient tumor elimination, also in immune privileged organs such as the brain. Fostering antitumor immunity has therefore become an important challenge in cancer therapy. This cannot only be achieved by immunotherapies as already standard treatments such as radiotherapy and chemotherapy modify the immune system. Consequently, the understanding of how the tumor, the tumor microenvironment, and immune system are modulated by cancer therapy is required for prognosis, prediction, and therapy adaption. The prospective, explorative, and observational IMMO-GLIO-01 trial was initiated to examine the detailed immune status and its modulation of about 50 patients suffering from primary glioblastoma multiforme (GBM) or anaplastic astrocytoma during standard therapy. Prior to the study, a flow cytometry-based assay was established allowing the analysis of 34 immune cell subsets and their activation state. Here, we present the case of the first and longest accompanied patient, a 53-year-old woman suffering from GBM in the front left lobe. In context of tumor progression and therapy, we describe the modulation of the peripheral immune status over 17 months. Distinct immune modulations that were connected to therapy response or tumor progression were identified. Inter alia, a shift of CD4:CD8 ratio was observed that correlated with tumor progression. Twice we observed a unique composition of peripheral immune cells that correlated with tumor progression. Thus, following up these immune modulations in a closely-meshed manner is of high prognostic and predictive relevance for supporting personalized therapy and increasing therapy success. Clinical Trial registration: ClinicalTrials.gov, identifier NCT02022384 (registered retrospectively on 13th of December, 2013).
Small cell carcinoma of the larynx treated by concurrent chemoradiotherapy: a case report
Authors: Susumu Nakahara, Norihiko Takemoto, Hidenori Inohara
Journal: Case Rep Otolaryngol (2012)
MeSH terms: Case Reports

Small cell carcinoma (SmCC) generally occurs in the lung and extrapulmonary SmCC is a relatively rare entity. Here, we present a case of a 42-year-old male with SmCC of the larynx diagnosed as cT3N0M0. Concurrent chemoradiotherapy using cisplatin (CDDP) and etoposide (VP-16) was given, which achieved complete response (CR). Lung metastasis became evident in 16 months whereas the locoregional control remained good. In spite of intensive chemotherapy using CDDP and irinotecan (CPT-11), the patient died of disease in 34 months after the first interview. Since the prognosis of laryngeal SmCC is extremely poor, organ preservation therapy should be considered instead of radical laryngectomy.
Giant osteoclasts in patients under bisphosphonates
Authors: Fabrice Mac-Way, Andrea Trombetti, Christian Noel, Marie-Hélène Lafage-Proust
Journal: BMC Clin Pathol (2014)
Keywords: bisphosphonate, bone biopsy, bone resorption, giant osteoclast, osteoporosis
MeSH terms: Case Reports

Background:
Bisphosphonates have been widely used for treatment of high bone resorption states. It lowers bone turnover by inhibiting osteoclasts bone resorption with various mechanisms of actions: inhibition of osteoclast formation and attachment to the bone surface, induction of metabolic injury, alteration of vesicle trafficking and induction of osteoclast apoptosis. Bone biopsies studies from patients under bisphosphonates have shown that some resorption parameters are decreased as expected but the number of osteoclasts seems not to be necessarily decreased. The description of osteoclasts morphology from patients treated with bisphosphonates has rarely been reported in the literature.
Case presentation:
We describe in this paper two patients treated with bisphosphonates from whom iliac crest bone biopsies have shown large, multinucleated and apoptotic osteoclasts that were not associated with bone resorption activities. The characteristics of these osteoclasts are described and the literature reviewed.
Conclusion:
The appropriate recognition of these giant osteoclasts in bone tissues from patients treated with bisphosphonates is of primary importance for bone pathologists and should not be interpreted as signs of increased bone resorption as seen in hyperparathyroidism, bone cancer or Paget's disease of bone.
Subacute Stroke in a Young Female: A Case of Moyamoya Syndrome Initially Anchoring with Anxiety
Authors: Saira Chaughtai, Zeeshan Chaughtai, Muhammad Shaheryar Haider, Hasnan M Ijaz, Sarah Elmedani, Mohamed Bakr, Mohammad A Hossain, Arif Asif
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Moyamoya disease is an arterial disorder causing stroke in a young patient. This is a chronic condition causing progressive cerebrovascular disease due to bilateral stenosis and occlusion of the arteries around the circle of Willis, with prominent arterial collateral circulation. It was first described in Japan and subsequently reported in other Asian countries, but infrequently found in the Western world. Interestingly, there may be racial differences in the presentation and subsequent prognostication of treatment of moyamoya. It is diagnosed with classic angiographic findings of stenosis or occlusion of the circle of Willis vessels. Here, we describe a 28-year-old Caucasian female who was initially diagnosed with anxiety when she presented with symptoms of impaired concentration and fatigue. After the development of remitting slurred speech and facial droop, magnetic resonance imaging and cerebral angiogram yielded the discovery of high-grade stenosis of the origin of the left middle cerebral artery with associated thrombosis in that area. She did well after getting surgery and rehabilitation. This demonstrates a unique presentation of prominent psychiatric symptoms initially thought to be anxiety and culminated in the finding of ischemic stroke in an adult patient with moyamoya.
Brittle Cornea Syndrome: Case Report with Novel Mutation in the PRDM5 Gene and Review of the Literature
Authors: Georgia Avgitidou, Sebastian Siebelmann, Bjoern Bachmann, Juergen Kohlhase, Ludwig M Heindl, Claus Cursiefen
Journal: Case Rep Ophthalmol Med (2015)

A 3-year-old boy presented with acute corneal hydrops on the left eye and spontaneous corneal rupture on the right eye. A diagnosis of brittle cornea syndrome was confirmed by molecular analysis. A novel mutation, the homozygous variant c.17T>G, p.V6G, was found in the gene for PR-domain-containing protein 5 (PRDM5) in exon 1. Brittle cornea syndrome is a rare connective tissue disease with typical ocular, auditory, musculoskeletal, and cutaneous disorders. Almost all patients suffer from declined vision due to corneal scarring, thinning, and rupture. The most common ophthalmologic findings include keratoconus, progressive central corneal thinning, high myopia, irregular astigmatism, retinal detachment, and high risk for spontaneous corneal or scleral rupture. In addition to describing the case with a novel mutation here we review the current literature on brittle cornea syndrome pathogenesis, clinical findings, and therapy.
Successful Rotational Atherectomy for an Angulated Calcified Lesion in an Anomalous Right Coronary Artery Using the "Mother-and-Child" Technique
Authors: Manabu Ogita, Satoru Suwa, Taketo Sonoda, Shuta Tsuboi, Katsumi Miyauchi, Hiroyuki Daida
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Percutaneous coronary intervention (PCI) involving the anomalous coronary artery is challenging with respect to difficulty in achieving stable catheterization. Rotational atherectomy (RA) can facilitate severely calcified lesions to improve stent delivery and stent expansion; however, its utility in tortuous and angulated coronary arteries is limited with difficulty in delivery of the RA burr. The mother-and-child technique is effective for complex PCIs with increased backup force for device delivery in such complicated cases. We report a case of successful rotational atherectomy using the "mother-and-child" technique with a Dio thrombus aspiration catheter for an angulated calcified lesion in an anomalous origin of the right coronary artery.
Proteomic Markers of Non-functional Overreaching During the Race Across America (RAAM): A Case Study
Authors: Edward K Merritt, David C Nieman, Brian R Toone, Arnoud Groen, Artyom Pugachev
Journal: Front Physiol (2019)
Keywords: raam, cycling, overreach, overtraining syndrome, proteomics, ultraendurance

In a previous study, proteomics procedures identified blood proteins as potential overreaching and overtraining biomarkers, and a targeted proteomics panel of 21 proteins was developed.
Purpose:
To measure targeted blood protein changes in an ultraendurance cyclist competing in RAAM.
Methods:
The athlete underwent testing 4-week pre-RAAM and 4-day post-RAAM to determine body composition and aerobic capacity. During RAAM training distress score (TDS) and body mass were measured daily. Power output and heart rate (HR) were measured during cycling. Blood sampling for proteomic analysis occurred 4 weeks, 24, and 2 h before the start, twice per day of the race, and after 1 and 4 days recovery.
Results:
The athlete completed the 4941 km race in 10.1 days at a speed of 24.5 km/h with 20 total hours of sleep. TDS was very low, 1, pre-RAAM and increased to very high, 47, at the finish. Post-RAAM maximal aerobic capacity and HR were 6.3 and 5.7% lower (61.6 vs. 57.5 mL.kg-1.min-1 and 192 bpm vs. 181 bpm). Body composition did not change. The change in blood proteins was calculated using pre-race samples and samples collected on days 8, 9, and recovery day 1. The blood proteins with the largest increase were complement component C7 (359%), complement C4-B (231%), serum amyloid A-4 protein (210%), inter-alpha-trypsin inhibitor heavy chain H4 (191%), and alpha-1-antitrypsin (188%).
Conclusion:
The RAAM athlete exhibited non-functional overreaching symptoms including increased training distress and decreased work capacity. Proteomic analysis indicated large increases for immune-related proteins involved with complement activation and the acute phase response, which could be useful biomarkers for non-functional overreaching.
The class inclusion question: a case study in applying pragmatics to the experimental study of cognition
Authors: Guy Politzer
Journal: Springerplus (2016)
Keywords: categorisation, class inclusion, cognitive development, privative ambiguity, relevance theory

For more than 70 years, Piaget's class-inclusion task (given, e.g., five asters and three tulips, the child is asked whether "there are more asters or more flowers") has been the object of experimental investigation. Inclusion is of considerable importance for cognitive science as it is a key concept for logical operations and knowledge representation. It is shown that the question can be characterised by a kind of privative ambiguity which is at the source of the younger children's answer, "more asters". A relevance-theoretic explanation of children's interpretation of the question and of the subsequent responses is expounded. This account can explain the effect of all the factors that are known to influence performance (e.g., role of collections, counting, typicality, qualification, syntax, etc.), a review of which is presented. It is further tested experimentally. The development of performance is explained on the basis of the way children disambiguate the question. This study exemplifies the two ways in which pragmatic analysis is pertinent to the study of children's (as well as adults') reasoning and judgement, namely in explaining and predicting participants' comprehension of the statements and questions, and in taking into account attribution processes that occur in the experimental setting.
Marine-Lenhart Syndrome: Case Report, Diagnosis, and Management
Authors: Danielle Neuman, Russ Kuker, Francesco Vendrame
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

The coexistence of thyroid functioning nodules and Graves' disease is called Marine-Lenhart syndrome. This condition is estimated to occur in 0.8-2.7% of patients with Graves' disease with few cases reported in the literature. Criteria for the diagnosis are not well defined. Here, we present a case of hyperthyroidism characterized by the presence of stimulating TSH receptor antibodies and severe bilateral exophthalmos. A thyroid uptake and scan revealed an elevated 24-hour iodine-131 uptake and a discrete hot nodule in the upper pole of the right lobe which was also observed with a thyroid ultrasound. The patient was diagnosed with Marine-Lenhart syndrome complicated by thyroid eye disease and was treated with methimazole followed by thyroidectomy and orbital decompression. We review the existing literature and propose criteria for the diagnosis and treatment of this condition.