OpenMed/multicare-articles huggingface dataset:
The Role of Acute Trigemino-Cardiac Reflex in Unusual, Non-Surgical Cases: A Review
Authors: Tumul Chowdhury, Bernhard Schaller
Journal: Front Neurol (2016)
Keywords: asystole, brainstem reflex, death, trigemino-cardiac reflex
MeSH terms: Review

Trigemino-cardiac reflex (TCR) is a well-established phenomenon that is mainly reported in the various surgical specialties. However, the role of this unique reflex is entirely unknown in other medicine domains. Therefore, the present mini-review aims to explore the role of TCR in such unusual cases and also highlights the importance of case reports for knowledge creation in such context.
Antenatal Indomethacin Treatment for Congenital Myotonic Dystrophy
Authors: Kyohei Yamaguchi, Hiroaki Tanaka, Fumi H Furuhashi, Kayo Tanaka, Eiji Kondo, Tomoaki Ikeda
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Myotonic dystrophy is an autosomal-dominant disorder. Its congenital type is the most severe form, with respiratory failure that can be a life-threatening event after birth. There are no antenatal treatments that can improve neonatal outcomes of myotonic dystrophy. We treated a fetus with congenital myotonic dystrophy by administering indomethacin to the 31-year-old Japanese mother affected by myotonic dystrophy and polyhydramnios. We observed increased fetal breathing movement and a reduction of the amniotic fluid volume. The baby was born at 37 weeks and discharged from the neonatal intensive care unit with a favorable outcome. Indomethacin treatment is likely to improve fetal lung function and to control the amniotic fluid volume. This report emphasizes the importance of further investigations regarding the optimal management of congenital myotonic dystrophy.
Milk alkali and hydrochlorothiazide: a case report
Authors: Babar Parvez, Chinenye Emuwa, Marquetta L Faulkner, John J Murray
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Hypercalcemia is a relatively common clinical problem in both outpatient and inpatient settings. Primary pathophysiology is the entry of calcium that exceeds its excretion into urine or deposition in bone into circulation. Among a wide array of causes of hypercalcemia, hyperparathyroidism and malignancy are the most common, accounting for greater than 90 percent of cases. Concordantly, there has been a resurgence of milk-alkali syndrome associated with the ingestion of large amounts of calcium and absorbable alkali, making it the third leading cause of hypercalcemia (Beall and Scofield, 1995 and Picolos et al., 2005). This paper centers on a case of over-the-counter calcium and alkali ingestion for acid reflux leading to milk alkali with concordant use of thiazide diuretic for hypertension.
Brincidofovir Use after Foscarnet Crystal Nephropathy in a Kidney Transplant Recipient with Multiresistant Cytomegalovirus Infection
Authors: Romain Vial, Christine Zandotti, Sophie Alain, Alexandre Decourt, Noémie Jourde-Chiche, Raj Purgus, Charleric Bornet, Laurent Daniel, Valérie Moal, Tristan Legris
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Background. Cytomegalovirus (CMV) antiviral drug resistance constitutes an increasing challenge in transplantation. Foscarnet is usually proposed when resistance for ganciclovir is suspected, but its use is limited by its nephrotoxicity. Case Presentation. We report a case of multiresistant CMV disease in a kidney transplant recipient. Foscarnet was prescribed after ganciclovir treatment failure in a patient with two mutations in the UL97 viral gene. Foscarnet induced biopsy-proven kidney crystal precipitation that resulted in severe acute transplant failure and nephrotic syndrome. Despite a large decrease in immunosuppression, CMV disease was not controlled and a salvage therapy with Brincidofovir (BCV), which is an oral lipid conjugate of cidofovir with limited nephrotoxicity, was attempted. Clinical and virological remission was observed after a 21-day course of BCV, despite mild and reversible liver toxicity. However, a new relapse could not be effectively cured by BCV due to a new mutation in the UL54 gene, which is known to confer resistance to cidofovir. A new course of foscarnet finally resulted in prolonged CMV remission. Herein, we present a review of foscarnet nephropathy cases in solid-organ transplanted patients. Conclusions. This unique case highlights the potential benefit of BCV use during resistant CMV infection, although mutations in the UL54 gene may limit its therapeutic efficacy. These findings need to be confirmed in clinical trials.
Endovascular treatment of pseudoaneurysms secondary to chronic pancreatitis: reports of two cases
Authors: Fabiana Seifert Santos, Karolaine Marcelina da Silva Sousa, Thiago Augusto Cadorin de Castro, Felipe Coelho Neto, Rodrigo Gomes de Oliveira, Walter Jr Boim de Araujo, Lilian Cabral Pereira Dos Santos, Raquel Canzi Almada de Souza
Journal: J Vasc Bras (2018)
Keywords: alcoholic pancreatitis, arteriography, chronic pancreatitis, endovascular surgery, pseudoaneurysm of the splenic artery
MeSH terms: Case Reports

Pseudoaneurysm secondary to chronic pancreatitis is a rare complication, but one with a high mortality rate. It is etiologically associated with chronic pancreatitis, and most diagnoses are made after rupture, which manifests with clinical signs of acute hemorrhage. Computed tomography plays an important role in diagnosis, but digital subtraction angiography remains the gold-standard method for diagnostic confirmation and for treatment planning. This article describes two cases of pseudoaneurysm in patients with chronic alcoholic pancreatitis; one involving the splenic artery and the other the gastroduodenal artery, complicated by thoracic and abdominal bleeding respectively. Both were successfully treated, using minimally invasive endovascular methods to implant coils and stent-grafts.
ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
Authors: Akira Umemura, Hiroyuki Nitta, Akira Sasaki, Takeshi Takahara, Yasushi Hasegawa, Go Wakabayashi
Journal: Case Rep Transplant (2014)

Herein, we describe an extremely rare experience of a patient with liver cirrhosis from hepatitis C virus (LC-HCV) who underwent an ABO-incompatible living donor liver transplantation (ABO-I-LDLT) using a hepatitis B core antibody (HBc-Ab) positive donor's liver graft. A 47-year-old Japanese woman with end stage LC-HCV, as a recipient, was preoperatively administered rituximab, mycophenolate mofetil, and steroids without plasma exchange. A routine ABO-I-LDLT procedure was applied using her daughter's HBc-Ab positive liver graft. Prophylaxis of the hepatitis B virus (HBV) infection using hepatitis B immunoglobulin (HBIG) and entecavir had been properly administered. Three months after the ABO-I-LDLT, HCV hepatitis relapsed. To date, this patient has been under antiviral therapy and prophylaxis of HBV infection using HBIG, while entecavir has been continued. The cognitions and techniques with regard to ABO-I-LDLT, prophylaxis of HBV cross infection, various patterns of immunosuppression, and antiviral therapy for HCV relapse are indispensable in managing a transplant recipient. According to the prophylaxis of HBV cross infection under ABO-I-LDLT, it may be very important to keep the HBs-Ab titer higher than usual for HBV naïve recipients, because severe systemic immunosuppression can cause de novo hepatitis.
Report of Three Cases of AKI Following Weight-Based Gentamicin Prophylaxis for IPP Implantation: Potential Concerns for Patients with Preexisting Conditions
Authors: Robert H Moore, Uzoma A Anele, Sarah C Krzastek, Adam P Klausner, J Tyler Roseman
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Despite the known nephrotoxicity of gentamicin, in 2008 the American Urological Association published guidelines recommending single high-dose weight-based gentamicin prophylaxis of 5 mg/kg for procedures involving urologic prostheses. These guidelines are based on the theoretical renal safety and improved antimicrobial activity of a single large dose of gentamicin. However, the risk of nephrotoxicity after weight-based gentamicin prophylaxis specifically in penile prosthetic surgery has never been established with evidence-based studies. This is of special concern in light of the known high rates of preexisting conditions in this specific population. Therefore, in order to expose potential safety issues, we present three cases of postoperative acute kidney injury following weight-based gentamicin prophylaxis after implantation of inflatable penile prostheses.
Predictors of Complications and Unfavorable Outcomes of Minimally Invasive Surgery Treatment in Elderly Patients With Degenerative Lumbar Spine Pathologies (Case Series)
Authors: Vladimir Klimov, Aleksey Evsyukov, Evgeniya Amelina, Sergey Ryabykh, Alexander Simonovich
Journal: Front Surg (2022)
Keywords: case series, complications, degenerative disorders, elderly patients, lumbar spine, minimally invasive surgery

Introduction:
The use of minimally invasive surgery (MIS) results in fewer adverse and more improved outcomes. However, the literature data describing the factors increasing the number of complications, reoperation frequency and unscheduled re-hospitalizations in older patients after MIS are contradictory. In this study, a large number of patients was investigated for the complications of minimally invasive surgical treatment of degenerative disease of the lumbar spine in older patients. The objective of the study was to determine the predictors of unfavorable outcomes in such patients.
Materials and methods:
1,013 patients underwent MIS (decompression alone, TLIF, LLIF, ALIF) in 2013-2017. All operations were performed with the participation of the authors (neurosurgeons). The patient's average age was 66. The following data were collected: BMI; CCI; presence of postoperative complications according to the Dindo-Clavien classification; unplanned readmission at 90 days; hospital length of stay (LOS); surgical complexity (low, intermediate, and high); surgical time; and risk factors. The cumulative reoperation rate was determined at 5-years follow-up.
Results:
A total of 256 patients suffered a complication (25.2%), 226 classified as mild (grade I, II, IIIA), and 30 - as severe (IIIB, IVA). Such factors as the surgical complexity, BMI > 30, surgical time, number of operated levels were associated with a significant risk of developing a complication. For patients with and without complications, LOS was 9.3 and 6.3 days, respectively (p < 0.0001), the unplanned readmission rate was 1.3%. 104 patients underwent 133 revision operations. The 5-year cumulative reoperation rate was 15.2%, and the reoperation index was 12.1%. The CCI had no statistically significant effect on the complication incidence after MIS. A higher risk of complications was found in patients who underwent intermediate-complexity surgery (MIS TLIF) compared with uncompounded (decompression alone) and more complex (MIS LLIF, MIS ALIF) surgical procedures (p < 0.001 and p = 0.001, respectively).
Conclusion:
A register of postoperative complications is an important tool for health quality assessment and choosing the best surgical option that helps to establish measures to reduce such complications. Using MIS for the treatment of elderly patients reduces the number of severe complications.
Chronic Dysuria Following Ginger ( Zingiber officinale) Use: A Case Report
Authors: Elham Akbarzadeh, Mojtaba Heydari, Fatemeh Atarzadeh, Amir Mohammad Jaladat
Journal: Galen Med J (2018)
Keywords: case report, dysuria, ginger, zingiber officinale
MeSH terms: Case Reports

Background:
Although ginger is considered a harmless remedial substance for a wide range of medical complaints, according to Persian medicinal texts, its long-term or high-dose consumption is potentially harmful.
Case report:
The case of a 43-year-old man, with a complaint of urinary stream interruption, dysuria, and flank pain, following a non-prescribed use of ginger was reported. The symptoms were reported to persist for four years, despite some medical referrals. Remarkably, the symptoms were attested to be shrinking eight weeks after ginger-intake cessation; besides, no further intervention was asserted.
Conclusion:
The history of herbal remedies use should be considered in patients with any unexplained urinary symptoms.
Fusion of ZMYND8 and RELA genes in acute erythroid leukemia
Authors: Ioannis Panagopoulos, Francesca Micci, Jim Thorsen, Lisbeth Haugom, Jochen Buechner, Gitte Kerndrup, Anne Tierens, Bernward Zeller, Sverre Heim
Journal: PLoS One (2013)
MeSH terms: Leukemia, Erythroblastic, Acute / genetics, Nuclear Proteins / genetics, Oncogene Proteins, Fusion / genetics, Transcription Factor RelA / genetics, Case Reports, Research Support, Non-U.S. Gov't, Base Sequence, Chromosomes, Artificial, Bacterial / genetics, Humans, In Situ Hybridization, Fluorescence, Infant, Male, Molecular Sequence Data, Nuclear Proteins / chemistry, Oncogene Proteins, Fusion / chemistry, Protein Structure, Tertiary, Reverse Transcriptase Polymerase Chain Reaction, Transcription Factor RelA / chemistry, Nuclear Proteins, Oncogene Proteins, Fusion, RELA protein, human, Transcription Factor RelA, ZMYND8-RELA fusion protein, human

Acute erythroid leukemia was diagnosed in a 4-month-old boy. Cytogenetic analysis of bone marrow (BM) cells showed a t(11;20)(p11;q11) translocation. RNA extracted from the BM was sequenced and analyzed for fusion transcripts using the software FusionMap. A ZMYND8-RELA fusion was ranked first. RT-PCR and direct sequencing verified the presence of an in frame ZMYND8-RELA chimeric transcript. Fluorescence in situ hybridization showed that the ZMYND8-RELA was located on the p12 band of der(11); therefore a cytogenetically invisible pericentric inversion in chromosome 11 must have taken place besides the translocation. The putative ZMYND8-RELA fusion protein contains the Zinc-PHD finger domain, a bromodomain, a PWWP domain, a MYND type of zinc finger of ZMYND8, and the entire RELA protein, indicating that it might act leukemogenically by influencing several cellular processes including the NF-kappa-B pathway.
Association of Beta-Thalassaemia and Hypogonadotropic Hypogonadism
Authors: Angela Vidal, Carolin Dhakal
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Thalassaemic syndromes are among the most common haemoglobinopathies and are associated with high morbidity and mortality. Because of the various treatments, a secondary endocrinopathy due to iron overload-haemosiderosis-can occur, causing hypopituitarism leading to hypogonadotropic hypogonadism (HH) and infertility. We present a case of secondary amenorrhoea in a patient with beta-thalassaemia and a history of multiple therapies in her adolescence, such as multiple transfusions, chemotherapy, and allogeneic bone marrow transplantation, who presented with HH and premature ovarian insufficiency.
A case report of Villar's nodule in a woman without surgical history
Authors: Nabonswindé Lamoussa Marie Ouédraogo, Safy Ilboudo, Abdoul Karim Ouattara, Aimé Sosthène Ouedraogo, Maurice Zida, Nayi Zongo, Dorcas Obiri-Yeboah, Edgard Ouangre, Jacques Simpore, Si Simon Traore
Journal: Int J Surg Case Rep (2018)
Keywords: burkina faso, endometriosis, umbilical primitive, villar’s nodule

Introduction:
Villar's nodule is an umbilical endometriosis without anterior or ongoing pelvic endometriosis. The primitive location of this nodule at the umbilical level is rare. Its etiopathogenesis remains unclear.
Presentation of case:
We report a case of umbilical endometriosis with unusual clinical expression in a woman in the reproductive years with no surgical history and no known history of endometriosis. Endometriosis manifested as progressive transformation of the normal umbilicus into several small nodules, with bleeding coinciding with the menstrual cycle. The diagnosis was confirmed by histology and surgical treatment consisted of omphalectomy.
Discussion:
Umbilical endometriosis is a rare disease that occurs naturally in patients with pelvic endometriosis. Etiopathogenesis of the disease is still unclear. In our patient, the appearance of the nodule was impressively, by a gradual transformation of the normal aspect of the umbilicus, into several small, slightly pigmented, firm, painful and concomitantly bleeding nodules during periods of menstruation. In the literature, this multinodular or budding form would be of exceptional observation.
Conclusion:
The characteristics of the umbilical tumor, associated with the cyclical nature of tumor bleeding in a patient without previous history of endometriosis, strongly suggest the diagnosis of Villar's nodule, but the confirmation is still histological. The treatment is always surgical and recurrence is very rare.
Case Report: Life-threatening pancytopenia with tislelizumab followed by cerebral infarction in a patient with lung adenocarcinoma
Authors: Hang-Yu Gu, Jing-Wen Zhao, Yin-Shuang Wang, Zhuo-Nan Meng, Xiu-Ming Zhu, Fu-Wei Wang, Ai-Hong Zheng, Guo-Qing Wu
Journal: Front Immunol (2023)
Keywords: cerebral infarction, hematological iraes, lung adenocarcinoma, pancytopenia, tislelizumab
MeSH terms: Adenocarcinoma of Lung / complications, Adenocarcinoma of Lung / drug therapy, Lung Neoplasms / complications, Lung Neoplasms / drug therapy, Lung Neoplasms / pathology, Pancytopenia / chemically induced, Pancytopenia / diagnosis, Case Reports, Aged, Cerebral Infarction, Granulocyte Colony-Stimulating Factor, Humans, Male, tislelizumab, Granulocyte Colony-Stimulating Factor

Immune checkpoint inhibitors (ICIs) are an integral antitumor therapy for many malignancies. Most patients show very good tolerability to ICIs; however, serious immune-related adverse events (irAEs) with ICIs have been well documented and prevent some patients from continuing ICIs or even become the direct cause of patient death. Cytopenia is a rare irAE but can be life-threatening. Here, we present the case of a 66-year-old male patient with metastatic lung adenocarcinoma who received two doses of chemotherapy + PD-1 antibody tislelizumab and developed pancytopenia after each dose. Although the first episode of pancytopenia resolved with a treatment regimen of granulocyte colony-stimulating factor (G-CSF), thrombopoietin (TPO), and red blood cell and platelet transfusion, the second episode showed extreme resistance to these treatments and improved only after the administration of steroids. His second pancytopenia episode resolved after a long course of treatment with methylprednisolone, G-CSF, TPO, hetrombopag and multiple red blood cell and platelet transfusions. However, he suffered a cerebral infarction when his platelet count was in the normal range and gradually recovered 1 week later. This case highlights the importance of the early recognition and management of hematological irAEs.
Paroxysmal Cold Hemoglobinuria in an Adult with Respiratory Syncytial Virus
Authors: Ryan Leibrandt, Kenneth Angelino, Monique Vizel-Schwartz, Ilan Shapira
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Paroxysmal cold hemoglobinuria (PCH) is a rare form of cold autoimmune hemolytic anemia first discovered in the early 20th century in adults with tertiary syphilis. Today, it is more commonly seen in children as a life-threatening anemia during a viral upper respiratory tract infection (URI). Although respiratory syncytial virus (RSV) has previously been reported to cause PCH in a child, herein we present the first documented case in an adult. The Donath-Landsteiner (DL) test, the diagnostic test for PCH, was positive on two separate occasions. The patient was treated successfully with warming and avoidance of cold temperatures. To facilitate identification of this rare entity by clinicians, we include a discussion about the pathophysiology, diagnosis, and treatment of PCH.
Autochthonous Nocardia cerradoensis Infection in Humans, Spain, 2011 and 2014
Authors: Maria Ercibengoa, Emilio Pérez-Trallero, José Maria Marimón
Journal: Emerg Infect Dis (2016)
Keywords: copd, nocardia cerradoensis, spain, autochthonous cases, bacteria, chronic obstructive lung disease, chronic obstructive pulmonary disease, human pathogen, immunocompromised persons, respiratory infections, transmission
MeSH terms: Nocardia / isolation & purification, Nocardia Infections / epidemiology, Case Reports, Aged, Aged, 80 and over, Brazil / epidemiology, Female, France / epidemiology, Humans, Immunocompromised Host, Male, Middle Aged, Spain / epidemiology

Nocardia cerradoensis was first isolated in 2003 in the El Cerrado region of Brazil; since then, only 2 human infections, in France and Spain, have been reported. We describe 3 autochthonous cases in residents of Spain during 2011 and 2014. Together these cases support the idea of an emerging global pathogenic microorganism.
Successful Coronary Protection during TAVI in Heavily Calcified Aortic Leaflets in Patient with Short and Low Left Coronary System
Authors: Mohamad Kabach, Abdulah Alrifai, Lawrence Lovitz, Mark Rothenberg, Cristiano Faber, Marcos Nores
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Transcatheter aortic valve replacement has been recently approved for patients who are high or intermediate risk for surgical aortic valve replacement. The procedure is associated with several known complications including coronary related complications. Coronary obstruction is rare but disastrous complication, and it is associated with a high mortality rate. Coronary protection technique has emerged as a preemptive technique to avoid this complication. We present a case of successful coronary protection during TAVR in severely calcified left cusp in patient with short and low left ostium.
Treatment dilemmas in a young man presenting with narcolepsy and psychotic symptoms
Authors: Victoria Fernandez, Sharon Davies, Nicola Walters
Journal: Case Rep Psychiatry (2011)
MeSH terms: Case Reports

Psychotic features can be present in both narcolepsy and psychosis, which can result in challenges in diagnosis and management. The prevalence of both conditions is low and the reports in young people are scarce. Our report illustrates the relevance of a thorough differential diagnosis as well as the need to explore treatment avenues based on the evidence available for both narcolepsy and psychosis symptoms to try and maximise the therapeutic impact.
Brucella Septic Arthritis: Case Reports and Review of the Literature
Authors: Fatehi Elnour Elzein, Nisreen Sherbeeni
Journal: Case Rep Infect Dis (2016)

Brucellosis is one of the commonest zoonotic infections worldwide. The disease is endemic in Saudi Arabia, the Middle East, and the Mediterranean area. Osteoarticular involvement is a frequent manifestation of brucellosis. It tends to involve the sacroiliac joints more commonly; however, spondylitis and peripheral arthritis are increasingly reported. Brucellosis can be overlooked especially in the presence of companion bacteria. Hence, it should be suspected in all patients with septic arthritis in endemic areas or in patients visiting such areas.
Optical Coherence Tomography Angiography of Two Choroidal Nevi Variants
Authors: Victor M Villegas, Armando L Monroig, Lazaro H Aguero, Stephen G Schwartz
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Optical coherence tomography angiography (OCT-A) is a recently established noninvasive technology for evaluation of the retinal and choroidal vasculature. The literature regarding the findings in choroidal nevi is scarce. We report the OCT-A findings associated with two different variants. Subject one had decreased vascular flow signal in the choroidal, choriocapillaris, deep retinal, and superficial retinal layers. Subject two had decreased vascular flow signal in the choroidal, choriocapillaris, and deep retinal layers with a normal vascular flow signal in the superficial retinal layer. To our knowledge, these patterns of decreased vascular flow signals have not been previously reported using OCT-A. This may be due to blockage from the choroidal nevus, true diminished blood flow (ischemia), or other factors.