OpenMed/multicare-articles huggingface dataset:
Adrenergic Inhibition with Dexmedetomidine to Treat Stress Cardiomyopathy during Alcohol Withdrawal: A Case Report and Literature Review
Authors: Zachary M Harris, Alvaro Alonso, Thomas P Kennedy
Journal: Case Rep Crit Care (2016)

Stress (Takotsubo) cardiomyopathy is a form of reversible left ventricular dysfunction with a heightened risk of ventricular arrhythmia thought to be caused by high circulating catecholamines. We report a case of stress cardiomyopathy that developed during severe alcohol withdrawal successfully treated with dexmedetomidine. The case involves a 53-year-old man with a significant history of alcohol abuse who presented to a teaching hospital with new-onset seizures. His symptoms of acute alcohol withdrawal were initially treated with benzodiazepines, but the patient later developed hypotension, and stress cardiomyopathy was suspected based on ECG and echocardiographic findings. Adjunctive treatment with the alpha-2-adrenergic agonist, dexmedetomidine, was initiated to curtail excessive sympathetic outflow of the withdrawal syndrome, thereby targeting the presumed pathophysiology of the cardiomyopathy. Significant clinical improvement was observed within one day of initiation of dexmedetomidine. These findings are consistent with other reports suggesting that sympathetic dysregulation during alcohol withdrawal produces ideal pathobiology for stress cardiomyopathy and leads to ventricular arrhythmogenicity. Stress cardiomyopathy should be recognized as a complication of alcohol withdrawal that significantly increases cardiac-related mortality. By helping to correct autonomic dysregulation of the withdrawal syndrome, dexmedetomidine may be useful in the treatment of stress-induced cardiomyopathy.
Cholecystectomy of an Intrahepatic Gallbladder in an Ectopic Pelvic Liver: A Case Report and Review of the Literature
Authors: Rachel Mathis, Joshua Stodghill, Timothy Shaver, George Younan
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Introduction:
Ectopic pelvic liver is an exceedingly rare condition usually resulting after repair of congenital abdominal wall defects. Intrahepatic gallbladder is another rare condition predisposing patients to cholelithiasis and its sequelae. We describe a cholecystectomy in a patient with an intrahepatic gallbladder in a pelvic ectopic liver.
Presentation of case:
A 33-year-old woman with a history of omphalocele repair as an infant presented with signs and symptoms of symptomatic cholelithiasis and chronic cholecystitis, however, in an unusual location. After extensive workup and symptomatic treatment, cholecystectomy was recommended and performed via laparotomy and hepatotomy using microwave technology for parenchymal hepatic transection.
Discussion:
Given the rare combination of an intrahepatic gallbladder and an ectopic pelvic liver, advanced surgical techniques must be employed for cholecystectomies, in addition to involvement of hepatobiliary experienced surgeons due to the distortion of the biliary and hepatic vascular anatomy.
Conclusion:
Cholecystectomy by experienced hepatobiliary surgeons is a safe and effective treatment for cholecystitis in patients with intrahepatic gallbladders in ectopic pelvic livers.
Acute Airway Obstruction from Megaoesophagus Secondary to Achalasia Evaluated with Flexible Bronchoscope
Authors: Jun D Parker
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

A 94-year-old female presented to the emergency department with acute expiratory stridor. In the absence of an otorhinolaryngologist, an urgent laryngoscopy was performed using a flexible bronchoscope by an anaesthesiologist in the emergency department leading to a change in management. Subsequent radiographs confirmed severe tracheal compression from megaoesophagus secondary to achalasia as the cause of acute airway obstruction. Use of flexible bronchoscope as a diagnostic tool by an anaesthesiologist to evaluate a patient presenting with signs of acute airway obstruction may lead to a safer and more careful airway management planning. Suggestions are also made regarding establishment of emergency surgical airways when conventional approaches fail.
Novel Variant in Exon 3 of the BMP4 Gene Resulted in Ectopic Posterior Pituitary, Craniocervical Junction Dysmorphism and Limb Anomaly
Authors: Valeria Calcaterra, Rossella Lamberti, Claudia Viggiano, Paola Baldassarre, Luigina Spaccini, Rosa Maria Alfano, Giana Izzo, Laura Grazia Valentini, Gianvincenzo Zuccotti
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Introduction. Pituitary differentiation involves a large number of transcription factors. In particular, BMP4 expression is fundamental for pituitary gland commitment from the ventral diencephalon, suppressing Shh expression in Rathke's pouch. Pathogenic variants in BMP4 are reported in the literature with a broad phenotypic spectrum, including pituitary and brain malformations. Case Presentation. A five-year-old girl came to medical attention following a mild cervical trauma with onset of cervical pain. On clinical examination at birth, postaxial polydactyly type B of the left hand was observed and removed at 10 months of age. A cervical radiography was performed, and a suspicion of craniocervical junction malformation was made. A magnetic resonance imaging of the cervical spine was made, showing an ectopic posterior pituitary, associated with dysmorphism of the craniocervical junction. The anthropometric parameters were pubertal Tanner stage 1, weight 16 kg (z-score: -1.09), height 107 cm (z-score: -0.76), and BMI 14 kg/m2 (z-score: -0.92). Normal hormonal assessment was detected. Genetic analysis via next generation sequencing showed a novel de novo heterozygous variant (c.277 G > T, p.Glu93 ∗ ) in exon 3 of BMP4. Discussion. We described a novel mutation in BMP4, resulting in ectopic posterior pituitary with normal hormonal assessment, associated to craniocervical junction dysmorphism and limb anomaly. It is important to monitor patient's growth and puberty and to screen the onset of symptoms related to the deficiency of one or more anterior as well as posterior pituitary hormones.
Neuromyelitis Optica in a Nepalese Man
Authors: Yogesh Subedi, Utsav Joshi, Sanjeeb Sudarshan Bhandari, Ashbina Pokharel, Ashbita Pokharel
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Background:
Neuromyelitis optica is a severely disabling inflammatory disorder of the central nervous system of autoimmune etiology that mainly affects the optic nerves and spinal cord. Here, we present a case report detailing a patient with tingling and weakness of right upper and lower limbs who was neuromyelitis optica immunoglobulin G-positive.
Case presentation:
A 46-year-old Nepalese man presented to the hospital with a history of tingling and weakness of right upper and lower limbs that developed over a period of two months. Clinical evaluation showed diminished power across all major muscle groups in the right upper and lower limbs. Magnetic resonance imaging of his cervical spine showed T1 iso- to hypointense signal and T2 hyperintense signal in central cervical spinal cord from first to sixth cervical level, probably suggestive of myelitis or demyelination. The patient was immediately started on intravenous methylprednisolone. The diagnosis of neuromyelitis optica was later confirmed with strongly positive neuromyelitis optica immunoglobulin G.
Conclusion:
In resource limited setting, in the absence of tests for neuromyelitis optica immunoglobulin G, treatment was started and the patient's condition started to get better. Hence, early initiation of aggressive immunosuppressive treatment is essential in such cases.
Benign subcutaneous emphysema: a rare and challenging entity a case report and review of the literature
Authors: Samuel M Christen, Joerg G Gruenert, Stefan Winsauer
Journal: Case Reports Plast Surg Hand Surg (2021)
Keywords: benign subcutaneous emphysema, gas gangrene, gas-forming bacteria, necrotizing soft tissue infection
MeSH terms: Case Reports

We report the case of a craftsman who developed a rapidly progressive subcutaneous emphysema of his forearm after a minor stab injury into the palm of his hand. Based on our case report we discuss differential diagnosis and management of acute subcutaneous emphysema.
Contrast media-assisted in-treatment cone beam CT during single-isocentre volumetric-modulated arc therapy for multiple brain metastases: a case study
Authors: Akihiro K Nomoto, Wataru Takahashi, Hideomi Yamashita, Akihiro Haga, Kiyoshi Yoda, Keiichi Nakagawa
Journal: BJR Case Rep (2016)

A direct visualization technique for verifying intrafractional localization accuracy of multiple brain metastases during single-isocentre volumetric-modulated arc therapy has been proposed using contrast media-assisted in-treatment cone beam CT (CBCT). Contrast-enhanced planning CT images were acquired immediately after intravenous bolus administration of iodized contrast media at a dose of 2 ml kg-1. Out of 41 nodules detected on the images, 8 lesions were contoured as high-risk gross tumour volumes (GTVs). Prior to each treatment, CBCT imaging was performed to match the skull structures with the planning CT images. Immediately after another intravenous bolus injection of the iodized contrast media at the same dose as administered for the planning CT imaging, contrast-enhanced CBCT images were acquired during volumetric-modulated arc therapy delivery, thereby providing direct verification of time-averaged tumour position during treatment. The planning target volume contours were overlaid with the in-treatment CBCT images, thereby allowing us to directly visualize the localization accuracy of each GTV when the beam delivery was completed. It was visually confirmed that each GTV was accurately localized inside each planning target volume during beam delivery.
Pseudo-progression with osimertinib after definitive chemoradiation in unresectable epidermal growth factor receptor mutation positive of stage III non-small cell lung cancer: A case report
Authors: Fei Ren, Yao Wang, Yongsheng Gao, Xiangjiao Meng
Journal: Front Oncol (2022)
Keywords: egfr mutation, nsclc, case report, osimertinib, pseudoprogression
MeSH terms: Case Reports

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) have been widely used in the treatment of locally advanced non-small cell lung cancer (NSCLC). The phenomenon of pseudoprogression in targeted therapy in EGFR-mutation NSCLC patients is rare. Here, we reported an EGFR-mutation-positive lung adenocarcinoma patient who was admitted to a hospital for cough and chest distress accompanied by shortness of breath. He underwent four cycles of chemotherapy with pemetrexed combined with carboplatin and concurrent radiotherapy in the third and fourth cycles. Then, he was treated by osimertinib maintenance therapy. After 11.5 months of osimertinib treatment, he was assessed to progressive disease by computed tomography. He underwent fiber bronchoscopy, and the biopsy pathology showed extensive necrosis without tumor cells. Until now, the patient has continued on osimertinib for 7 months without relapse or metastasis. As far as we know, we are the first to report pseudoprogression in osimertinib maintenance after definitive chemoradiation. This study reminds the clinicians to distinguish pseudoprogression from osimertinib-induced progression and avoid abandoning effective treatments.
Clinical commentary: obstetric and respiratory management of pregnancy with severe spinal muscular atrophy
Authors: Daniel Flunt, Natasha Andreadis, Collette Menadue, Alec W Welsh
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

We present a combined obstetric and respiratory perspective on two pregnancies for a woman with severe Type 2 Spinal Muscular Atrophy (SMA). Our patient had the lowest prepregnancy weight (20 kg) and vital capacity of 0.34 L (VC 11% predicted) yet to be reported in the sparse literature on pregnancy with SMA. She delivered two live healthy infants via planned caesarean section without pregnancy or neonatal complication. We describe the respiratory and obstetric management techniques used for a pregnancy with this degree of respiratory compromise.
Visual complaints in pregnancy: (pre)eclampsia as a chameleon
Authors: Johanna Wiedemann, Lebriz Altay, Antje Neugebauer, Tim Krohne, Claus Cursiefen
Journal: GMS Ophthalmol Cases (2022)
Keywords: (pre)eclampsia, dic, pres, diabetes type i, pregnancy
MeSH terms: Case Reports

Objective:
The visual system often is affected in patients with preeclampsia and even more in cases of eclampsia, a life-threatening pregnancy complication. Symptoms include blurred vision and deterioration of visual acuity. Pregnancy can also affect pre-existing conditions, such as diabetic retinopathy. In this case series, we describe three patients with the same underlying condition, i.e. (pre)eclampsia who experienced acute visual disturbance whereas the final diagnosis was different: disseminated intravascular coagulopathy (DIC), posterior reversible encephalopathy syndrome (PRES), and diabetic retinopathy.
Methods and results:
All patients underwent a thorough slit lamp examination and ocular coherence tomography (OCT). All patients presented with acute impaired vision and subretinal fluid and-/or fibrin.
Conclusions:
These cases highlight the importance of early involvement of ophthalmologists when pregnant women complain about visual disorders.
Lacrimal sac cysticercosis: a rare site for manifestation
Authors: Amita Raoot
Journal: Case Rep Ophthalmol Med (2014)

Cysticercosis, a parasitic tissue infestation caused by larval cysts (cysticercus cellulosae) of the pork tapeworm, Taenia solium, most commonly affects the central nervous system, subcutaneous tissue, skeletal muscle, heart muscle, and the eye. Ocular adnexal infestation in cysticercosis can involve various sites within the eye like vitreous humor, subretinal tissue, extraocular muscle, and lacrimal gland. In this case report, a lump slightly below and medial to inner corner of eye, surgically removed from a 21-year-old male patient, was diagnosed as case of lacrimal sac cysticercosis on histopathological examination. To our knowledge, this is the one of rare sites for manifestation of cysticercus cellulosae.
Neglected Fournier's Gangrene Caused by Acinetobacter baumannii: A Rare Case Report
Authors: Arif Emre, Mehmet Sertkaya, Sami Akbulut, Yakup Duman, Ilhami Taner Kale
Journal: Case Rep Surg (2016)

Fournier's gangrene, rare but life threatening disease, is characterized by an acute necrotic infection of the scrotum, penis, or perineum. Fournier's gangrene is a mixed infection caused by both aerobic and anaerobic bacteria. Fournier's gangrene caused by multidrug resistant Acinetobacter baumannii have been reported rarely. The mainstay of treatment is prompt recognition and a combination of antibiotics with radical debridement. We describe a case of a 56-year-old male patient presenting with neglected Fournier's gangrene caused by Acinetobacter baumannii. Many treatment modalities including broad-spectrum antibiotics, aggressive debridement, negative pressure wound therapy, diversion colostomy, and partial-thickness skin grafts were applied to save the patient's life.
More Delusions May Be Observed in Low-Proficient Multilingual Alzheimer's Disease Patients
Authors: Yi-Chien Liu, Yen-Ying Liu, Ping-Keung Yip, Kyoko Akanuma, Kenichi Meguro
Journal: PLoS One (2015)
MeSH terms: Alzheimer Disease / psychology, Delusions / etiology, Language Disorders / etiology, Multilingualism, Case Reports, Comparative Study, Activities of Daily Living, Aged, Aged, 80 and over, Case-Control Studies, Cognition, Delusions / epidemiology, Delusions / psychology, Emotions, Female, Humans, Incidence, Language Disorders / epidemiology, Language Disorders / psychology, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Paranoid Behavior / etiology, Paranoid Behavior / psychology, Psychological Trauma / psychology, Severity of Illness Index, Taiwan, Temporal Lobe / pathology, Temporal Lobe / physiopathology

Background:
Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion.
Methods:
We recruited 21 patients with Alzheimer's disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), were administered.
Results:
The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls.
Conclusion:
Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive performance was not significantly different between our groups, language may still affect their delusion.
Neutrophilic erythrophagocytosis in myelodysplastic syndrome and cold agglutinin disease co-occurrence
Authors: Asra Amelirad, Parisa Modaresi, Hassan Soltani
Journal: Clin Case Rep (2023)
Keywords: anemia, autoimmune, cold agglutinin disease, hemolytic, myelodysplastic syndromes, phagocytosis
MeSH terms: Case Reports

In this article, we report the rare phenomenon of erythrophagocytosis by neutrophils in peripheral blood smear of a 56-year-old male patient with concurrent myelodysplastic syndrome and cold agglutinin disease.
Reaching and engaging people: Analyzing tweeting practices of large U.S. police departments pre- and post- the killing of George Floyd
Authors: Beidi Dong, Xiaoyun Wu
Journal: PLoS One (2022)
MeSH terms: Police, Social Media, Homicide, Humans, Law Enforcement / methods, United States

Finding ways to improve police legitimacy and police-community relations has for long been an important social issue in the United States. It becomes particularly urgent following the murder of George Floyd on May 25th, 2020. An emerging area that holds potential in remediating police-community relations pertains to the use of social media by police. Yet, this body of research stays highly exploratory (e.g., case studies based on a small sample of agencies) and different viewpoints exist regarding the objectives of police social media usage. The current study identified 115 large police departments in the U.S. and collected their tweets over a 4-month period between 4/1/2020 and 7/31/2020. We investigated how police agencies (both individually and as an aggregate) leveraged social media to respond to the nationwide protests directed at the police and community reactions to such responses. We found that police agencies tweeted more frequently in the immediate aftermath of the murder and posted an increased number of civil-unrest related tweets. The public showed a greater interest in engaging with law enforcement agencies (i.e., average favorite and retweet counts) following the murder. A great variability emerged across agencies in their responses on social media, suggesting that examining only a handful of agencies or a particular dimension of social media usage would limit our understanding of police behaviors and citizen interactions on social media. In conclusion, we suggested a few avenues for future research (and practices) on responsible and effective use of social media by police, while pointing out the challenges associated with such inquiries.
Schizophrenia and Hyperostosis Frontalis Interna with History of Head Injury
Authors: Fatima Elghazouani
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Hyperostosis frontalis interna is an irregular thickening of the frontal bone. Its etiology is unknown. It has been rarely linked with schizophrenia and head injury. Case Presentation. We describe an unusual case of a 44-year-old female with schizophrenia and hyperostosis frontalis interna having a history of head trauma. At the age of 3 years, she had a head injury that could be classified as mild traumatic brain injury. She presents a family history of schizophrenia. She was admitted for resistant schizophrenic disorder. The cranial computed tomography showed bilateral and asymmetrical hyperostosis of the frontal bone that was more pronounced on the right side. This corresponds to the impact of the trauma with frontal atrophy without any metabolic or endocrinal abnormalities. Conclusion. We surmise that the long-term pathological effects of traumatic brain injury, including hyperostosis frontalis interna, are likely to interact with genetic vulnerability and may lead to schizophrenic disorder.
Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision (™) videolaryngoscope
Authors: Mohamed El-Tahan, D John Doyle, Alaa M Khidr, Ahmed G Hassieb
Journal: F1000Res (2014)

We describe the insertion of the double lumen endobronchial tube (DLT) using a non-channeled standard blade of the King Vision (TM) videolaryngoscope for one lung ventilation (OLV) in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision (™) videolaryngoscope. We conclude that the use of King Vision (™) videolaryngoscope could offer an effective method of DLT placement for OLV.