OpenMed/multicare-articles huggingface dataset:
Primary segmental volvulus mimicking ileal atresia
Authors: Raghu Shankar, Sadashiva Rao, Kishan B Shetty
Journal: J Neonatal Surg (2013)
Keywords: ileal atresia, neonate, primary segmental volvulus
MeSH terms: Case Reports

Neonatal intestinal volvulus in the absence of malrotation is a rare occurrence and rarer still is the intestinal volvulus in absence of any other predisposing factors. Primary segmental volvulus in neonates is very rare entity, which can have catastrophic outcome if not intervened at appropriate time. We report two such cases, which were preoperatively diagnosed as ileal atresia and intraoperatively revealed to be primary segmental volvulus of the ileum.
Surgical management of the cesarean scar ectopic pregnancy: a case report
Authors: Anisodowleh Nankali, Mina Ataee, Haleh Shahlazadeh, Sara Daeichin
Journal: Case Rep Obstet Gynecol (2013)

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. The authors reported here a case of cesarean scar pregnancy (CSP) with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from the hospital without any complications.
Case report: A complex case of valve-in-valve TAVI and left bundle branch pacing for severe aortic regurgitation with partially corrected type A aortic dissection and low ejection fraction
Authors: Peter Marko Mihailovič, David Žižek, Luka Vitez, Primoz Holc, Tomislav Klokočovnik, Matjaž Bunc
Journal: Front Cardiovasc Med (2023)
Keywords: aortic regurgitation (ar), cardiac resychronisation therapy, heart failure, left bundle area pacing, left bundle branch pacing (lbbp), transcatheter aortic valve implantation (tavi), valve in valve implantation, valve in valve transcatheter aortic valve implantation
MeSH terms: Case Reports

Background:
Aortic regurgitation is a major concern following transcatheter aortic valve implantation (TAVI), as even low-grade regurgitation is associated with increased mortality. This is of particular concern to patients with pre-existing aortic disease who are at increased risk of TAVI valve slippage. Furthermore, conduction system disturbances after TAVI, namely left bundle branch block (LBBB), may have an additional detrimental effect on cardiac function.
Case presentation:
This report documents a successful treatment strategy in a frail patient with a bicuspid aortic valve and aortic disease after valve-sparing surgical repair in 1998, who subsequently developed aortic stenosis and underwent TAVI with an Evolut R self-expanding aortic valve. The progression of aortic disease, aortic root dilatation, and leaflet degeneration over the following years caused aortic regurgitation of the self-expanding aortic valve, resulting in left ventricular dilatation and heart failure along with LBBB and left ventricular (LV) mechanical dyssynchrony. Diagnostic workup of the patient showed persistence of the aneurysm distal to the graft with a dissection spanning the ascending aorta, arch, and terminating proximal to the aortic isthmus. After consideration by the cardiac team, a balloon-expandable valve was chosen for a valve-in-valve (ViV) procedure to provide sufficient radial force to expand the existing valve and correct the regurgitation. Due to the anatomy, a J-wire and pigtail catheter were successfully used for a safe approach and placement of the valve. Following the procedure, intermittent complete atrioventricular block was observed in addition to the pre-existing left bundle branch block, necessitating resynchronization pacing. Due to anatomical considerations, ease of placement, and the expected good level of resynchronization due to the proximal block, we opted for left bundle branch pacing, which showed improvement in left ventricular dyssynchrony and LV function at follow-up.
Conclusion:
Valve-in-valve implantation of a balloon-expandable Myval TAVI device to treat aortic regurgitation caused by slippage and right leaflet disfunction of slef valve is feasible in challenging anatomical scenarios. Left bundle branch pacing is a viable alternative to correct mechanical dyssynchrony in complex patients with LBBB and anatomical challenges necessitating resynchronization.
One-stop interventional procedure for bicuspid aortic stenosis in a patient with coexisting aortic coarctation: a case report
Authors: Xingwei He, Menaka Dhuromsingh, Wanjun Liu, Qiang Zhou, Hesong Zeng
Journal: Front Cardiovasc Med (2023)
Keywords: aortic coarctation, bicuspid aortic valve, case report, interventional procedure, one'stop
MeSH terms: Case Reports

Introduction:
Coarctation of the aorta (CoA) is usually diagnosed and corrected early in life. Most untreated patients with CoA usually die before 50 years of age. Adult patients with concomitant CoA and severe bicuspid aortic stenosis are relatively rare and present complex management challenges without standard guidelines.
Case summary:
A 63-year-old female patient with uncontrolled hypertension was admitted due to chest pain and dyspnea upon exertion (NYHA grades III). Echocardiogram showed a severely calcified and stenotic bicuspid aortic valve (BAV). A severe stenotic calcified eccentric aortic coarctation 20 mm distal to the left subclavian artery (LSA) was discovered by computed tomography (CT) angiography. Following consultation with the cardiac team and patient willingness, we performed a one-stop interventional procedure to repair both defects. First, a cheatham-platinum (CP) stent was implanted via the right femoral access, immediately distal to the LSA. Due to the markedly twisted and angled descending aortic arch, we chose to perform transcatheter aortic valve replacement (TAVR) via the left common carotid artery. The patient was discharged and followed up for 1 year without symptoms.
Discussion:
Although surgery is still the main treatment for these diseases, it is not suitable for high-risk surgical patient. Transcatheter intervention for patients with severe aortic stenosis complicated with CoA simultaneously is rarely reported. The success of this procedure depends on the patient's vascular condition, the skills of the heart team, and the availability of the technical platform.
Conclusion:
Our case report demonstrates the feasibility and efficacy of a one-stop interventional procedure in an adult patient with concurrent severely calcified BAV and CoA via two different vascular approaches. Transcatheter intervention, in contrast to traditional surgical approaches or two-stop interventional procedures, as a minimally invasive and novel method, offers a wider range of therapeutic methods for such diseases.
A Case of Descending Necrotizing Mediastinitis in a Previously Healthy Child
Authors: Toshihiko Okumura, Nobuyuki Tetsuka, Makoto Yamaguchi, Takako Suzuki, Yuka Torii, Jun-Ichi Kawada, Yoshinori Ito
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Descending necrotizing mediastinitis (DNM) is a rare complication of oropharyngeal and cervical infection, especially in children. We report a case of DNM secondary to a cervical abscess in a previously healthy 1-year-old boy. The patient presented with redness and swelling of the neck and fever. He was treated with an antimicrobial agent for the diagnosis of cervical lymphadenitis. On the sixth day, a huge mediastinal abscess was found, and he was admitted to the intensive care unit. He was successfully treated with surgical drainage and appropriate antimicrobial therapy. The pus culture isolated multiple bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Although we did not use an antimicrobial agent covering MRSA, the symptoms and test results improved. Washing with drainage was effective. The patient required multidisciplinary treatment, and we collaborated with specialists in other departments. DNM is a severe disease in which team medical care is needed to provide appropriate treatment.
Acute Achilles Paratendinopathy following Major Injury of the Crural Fascia in a Professional Soccer Player: A Possible Correlation?
Authors: Gabriele Mattiussi, Michele Turloni, Pietro Tobia Baldassi, Carlos Moreno
Journal: Case Rep Orthop (2016)

Background. The anatomy and mechanical properties of the Crural Fascia (CF), the ubiquitous connective tissue of the posterior region of the leg, have recently been investigated. The most important findings are that (i) the CF may suffer structural damage from indirect trauma, (ii) structural changes of the CF may affect the biomechanics of tissues connected to it, causing myofascial pain syndromes, and (iii) the CF is in anatomical continuity with the Achilles paratenon. Consistent with these points, the authors hypothesize that the onset of acute Achilles paratendinopathy may be related to histological and biomechanical changes of the CF. Case Presentation. A professional male football player suffered an isolated injury of the CF, interposed between the soleus and medial gastrocnemius (an atypical site of injury) with structural connective integrity of the muscles. After participating in the first official match, two and a half months after the trauma, he has unexpectedly demonstrated the clinical picture of acute Achilles paratendinopathy in the previously injured limb. Conclusions. Analysis of this case suggests that the acute Achilles paratendinopathy may be a muscle injury complication from indirect trauma of the calf muscle, if a frank and extensive involvement of the CF were to be ascertained.
Extra Corporeal Membrane Oxygenation (ECMO) in three HIV-positive patients with acute respiratory distress syndrome
Authors: Francesco Giuseppe De Rosa, Vito Fanelli, Silvia Corcione, Rosario Urbino, Chiara Bonetto, Davide Ricci, Mauro Rinaldi, Giovanni Di Perri, Stefano Bonora, Marco V Ranieri
Journal: BMC Anesthesiol (2014)
Keywords: aids, ards, ecmo, haart, hiv, immunocompromised patients, legionella, pjp, pneumonia
MeSH terms: Extracorporeal Membrane Oxygenation / methods, HIV Infections / complications, Respiratory Distress Syndrome / therapy, Case Reports, Adult, Fatal Outcome, Female, Humans, Intensive Care Units, Male, Patient Care Team / organization & administration, Prognosis, Quality of Life, Respiratory Distress Syndrome / etiology, Respiratory Distress Syndrome / physiopathology, Severity of Illness Index, Treatment Outcome, Young Adult

Background:
Extracorporeal membrane oxygenation (ECMO) is a life-saving bridging procedure in patients with severe acute respiratory distress syndrome (ARDS). Official indications for ECMO are unclear for immunocompromised and HIV-positive patients affected by severe hypoxemia. Uncertainties are related to prognosis and efficacy of treatment of the underlying disease. However, the care of patients with HIV infection has advanced since the introduction of highly active antiretroviral therapy (HAART), with increased life expectancy and decreased mortality.
Case presentation:
Three HIV-infected patients with AIDS were admitted to ICU and were treated with ECMO: a 21 years old Caucasian female with congenital HIV infection presented with Pneumocystis jirovecii pneumonia (PJP); a 38 years old Caucasian female with HIV-HCV infection and L. pneumophila pneumonia; a 24 years old Caucasian male with fever, cough weight loss and PJP pneumonia. Two patients were alive, with a good immunovirological profile and they went back to their previous quality of life. The last patient died with septic shock after three months of ICU stay.
Conclusion:
ECMO was effective in three HIV-positive patients with an otherwise fatal respiratory failure. All patients had severe immunosuppression and/or limited antiretroviral options. A multidisciplinary critical team is needed to individualize the use of ECMO in immunocompromised patients, including those with HIV infection.
Warthin-like papillary carcinoma of the thyroid gland: case report and review of the literature
Authors: Panagiotis Paliogiannis, Federico Attene, Federica Trogu, Mario Trignano
Journal: Case Rep Oncol Med (2012)

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.
Case Report: Post-Partum SARS-CoV-2 Infection After the First French Uterus Transplantation
Authors: Jean Marc Ayoubi, Marie Carbonnel, Niclas Kvarnström, Aurelie Revaux, Marine Poulain, Sarah Vanlieferinghen, Yves Coatantiec, Mathilde Le Marchand, Morgan Tourne, Paul Pirtea, Renaud Snanoudj, Morgan Le Guen, Pernilla Dahm-Kähler, Catherine Racowsky, Mats Brännström
Journal: Front Surg (2022)
Keywords: uterus transplantation, immunotherapy, covid-19, sars-cov-2, case report
MeSH terms: Case Reports

Absolute uterus factor infertility, whether congenital or acquired, renders the woman unable to carry a child. Although uterus transplantation (UTx) is being increasingly performed as a non-vital procedure to address this unfortunate condition, the immunosuppression required presents risks that are further compounded by pregnancy and during the puerperium period. These vulnerabilities require avoidance of SARS-CoV-2 infection in pregnant UTx recipients especially during the third trimester, as accumulating evidence reveals increased risks of morbidity and mortality. Here we describe a successful UTx case with delivery of a healthy child, but in which both mother and neonate developed asymptomatic SARS-CoV-2 infection seven days after RNA vaccination, on day 35 post-partum. Although the patient was successfully treated with a combination therapy comprised of two monoclonal antibodies, this case highlights the challenges associated with performing UTx in the era of Covid-19. More broadly, the risks of performing non-vital organ transplantation during a pandemic should be discussed among team members and prospective patients, weighing the risks against the benefits in improving the quality of life, which were considerable for our patient who achieved motherhood with the birth of a healthy child.
Cleidocranial dysplasia: a case report
Authors: Gülay Karagüzel, Filiz Azar Aktürk, Emelgül Okur, Halit Reşit Gümele, Yusuf Gedik, Ayşenur Okten
Journal: J Clin Res Pediatr Endocrinol (2010)
Keywords: cleidocranial dysplasia, aplasia of clavicle, unclosed fontanelle
MeSH terms: Cleidocranial Dysplasia / diagnosis, Case Reports, Age Determination by Skeleton, Bone and Bones / abnormalities, Child, Preschool, Cleidocranial Dysplasia / diagnostic imaging, Cleidocranial Dysplasia / genetics, Core Binding Factor Alpha 1 Subunit / genetics, Coxa Vara / diagnostic imaging, Cranial Sutures / abnormalities, Humans, Joint Instability / diagnostic imaging, Joint Instability / etiology, Male, Pubic Symphysis / diagnostic imaging, Core Binding Factor Alpha 1 Subunit

Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disease. CCD is caused by mutation in the gene on 6p21 encoding transcription factor CBFA1, i.e. runt-related transcription factor 2(RUNX2). The disease is characterized by a persistently open anterior fontanelle and skull sutures, hypoplastic or aplastic clavicles, dental abnormalities, short stature, a wide pubic symphysis, and a variety of other skeletal changes. A major finding of CCD is hypoplasia or aplasia of clavicular bones resulting in the ability of the patient to approximate the shoulders. Delayed closure of the anterior fontanelle and of metopic sutures causes frontal bossing. We report a case of CCD in a 3.5-year-old boy who referred to our clinic because of an unclosed anterior fontanelle and emphasize the importance of clinical findings in CCD.
Successful Removal of a Chronic Aspirated Foreign Body after Twelve Years
Authors: Radhika Z Reddy, Yvonne M Carter, David W Hsia
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Chronic retention of aspirated foreign bodies is rare but can result in indolent systemic and respiratory symptoms. Bronchoscopy may show features of tissue reaction to the foreign body, including granulation tissue, endobronchial stenosis, strictures, edema, and airway distortion. The diagnosis of foreign body aspiration is often difficult to establish since some patients may not give a clear history of aspiration or may present late. In addition, patients may be misdiagnosed with chronic pneumonia, bronchitis, asthma, or malignancy. We present the case of a 42-year-old male who had a chronically retained piece of an aluminum beverage container in the left mainstem bronchus for 12 years. Careful history, radiographic evaluation, and bronchoscopic examination revealed the foreign body, which was successfully extracted by rigid bronchoscopy.
Case Report: Prominent Brainstem Involvement in Two Patients With Anti-CASPR2 Antibody-Associated Autoimmune Encephalitis
Authors: Pei Liu, Miao Bai, Chao Ma, Yaping Yan, Gejuan Zhang, Songdi Wu, Zunbo Li, Daidi Zhao, Kaixi Ren, Hongzeng Li, Jun Guo
Journal: Front Immunol (2021)
Keywords: autoimmune, brainstem, contactin-associated protein-like 2, encephalitis, immunoglobulin g1
MeSH terms: Autoantibodies / immunology, Autoimmune Diseases / immunology, Brain Stem / immunology, Encephalitis / immunology, Case Reports, Research Support, Non-U.S. Gov't, Autoimmune Diseases / diagnosis, Brain Stem / diagnostic imaging, Encephalitis / diagnosis, Female, Humans, Magnetic Resonance Imaging / methods, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Autoantibodies, anti-CASPR2 autoantibody

Anti-contactin-associated protein-like 2 (CASPR2) antibody-associated autoimmune encephalitis is commonly characterized by limbic encephalitis with clinical symptoms of mental and behavior disorders, cognitive impairment, deterioration of memory, and epilepsy. The classical lesions reported are located at the medial temporal lobe or hippocampus, whereas prominent brainstem lesions have not been addressed to date. Herein, we reported two patients mimicking progressive brainstem infarction with severe neurological manifestations. On brain magnetic resonance imaging (MRI), prominent brainstem lesions were noted, although multifocal lesions were also shown in the juxtacortical and subcortical white matters, basal ganglia, hippocampus, and cerebellar hemisphere. Unexpectedly and interestingly, both cases had detectable CASPR2 antibodies in sera, and an exclusive IgG1 subclass was documented in the further analysis. They were treated effectively with aggressive immunosuppressive therapies including corticosteroids, intravenous immunoglobulin G, and rituximab, with the first case achieving a rapid remission and the other undergoing a slow but gradual improvement. To the best of our knowledge, this is the first report on prominent brainstem involvement with definite MRI lesions in anti-CASPR2 antibody-associated autoimmune encephalitis, which helps to expand the clinical spectrum of this rare autoimmune disease and update the lesion patterns in the CNS.
Acute right upper extremity ischemia resulting from true aneurysmof right brachial artery: A case report
Authors: Niki Tadayon, Sina Zarrintan, Seyed Mohammad Reza Kalantar-Motamedi
Journal: J Cardiovasc Thorac Res (2020)
Keywords: acute limb ischemia, brachial artery, revascularization, true aneurysm
MeSH terms: Case Reports

We report a case of 66-year-old woman with true aneurysm of the right brachial artery. She presented with acute upper extremity ischemia. The hand was cold and parenthesized and distal pulses were absent. CT angiography (CTA) revealed a 20*25 mm true brachial artery aneurysm. The aneurysm was thrombosed without distal run-off. We excised the aneurysm and reestablished the arterial flow by a reverse saphenous interposition graft. The postoperative course was uneventful.
Disseminated Talaromyces marneffei Infection in a Non-HIV Infant With a Homozygous Private Variant of RELB
Authors: Xiaofang Ding, Han Huang, Lili Zhong, Min Chen, Fang Peng, Bing Zhang, Xinyu Cui, Xiu-An Yang
Journal: Front Cell Infect Microbiol (2021)
Keywords: relb, talaromyces marneffei, combined immunodeficiency, next generation sequencing, non-human immunodeficiency virus (hiv)
MeSH terms: Mycoses / diagnosis, Talaromyces, Transcription Factor RelB / genetics, Case Reports, Research Support, Non-U.S. Gov't, Female, HIV Seronegativity, Humans, Infant, Lung, RELB protein, human, Transcription Factor RelB, Talaromyces marneffei, talaromycosis

Objective:
This study presents a relatively rare case of disseminated Talaromyces marneffei (T. marneffei) infection in an HIV-negative patient.
Methods:
An 8-month-old girl was hospitalized because of uncontrollable fever and cough for 6 days. Routine laboratory tests, biochemical detection, immunological tests, pathogenic examination, and imaging inspection were performed. Genetic tests of trio whole genome sequencing (Trio-WES), trio copy number sequencing (Trio-CNVseq), and Sanger sequencing were conducted to identify pathogenic variants. In silico analysis of the sequence alignment and structural modeling results was carried out to study the possible pathogenicity of the identified variant. Western blotting was performed to investigate the expression of the identified gene at the protein level.
Results:
Enhanced CT and MRI scanning demonstrated thymic dysplasia, diffuse pulmonary and liver nodules, and many balloon-like air sacs in both lungs. The white blood cell count, neutrophil count, and neutrophil ratio were normal or elevated. The patient was HIV-negative and bone marrow and blood culture showed T. marneffei infection. Total lymphocyte count, CD3+ T lymphocyte count, CD3+CD4+ T lymphocyte count, CD3+CD8+ T lymphocyte count, and NK cell count decreased, while the number of CD19 positive B cells increased. However, the ratio of CD3+CD4+:CD3+CD8+ T cells increased. Trio-WES identified a homozygous private variant of NM_006509: c.400_c.401insAGC/p.Lys134 delinsLysGln in RELB and Sanger sequencing validated the result. Structural modeling indicated that the variant may be pathogenic. Reverse transcription-polymerase chain reaction and Western blot analysis showed that the expression of RelB in the patient was lower than that in the healthy controls at mRNA and protein levels.
Conclusion:
This is the first report on disseminated T. marneffei infection in a patient with a homozygous private variant of RELB.