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Case Reports in Medicine

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https://www.readbyqxmd.com/read/28713431/an-unexpected-cause-of-bradycardia-in-a-patient-with-bacterial-meningitis
#1
Petros Ioannou, Magdalini Velegraki, Stella Soundoulounaki, Achilleas Gikas, Diamantis P Kofteridis
Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28713430/incidental-thrombus-in-transit-causing-embolic-stroke
#2
Brian Malm, Paul Hermany, Alan Morrison
Thrombus in transit leading to paradoxical systemic arterial embolism is a rare echocardiographic finding in patients presenting with embolic stroke. We present a case of a patient who had an atrial thrombus in transit discovered incidentally and later suffered a fatal stroke. Etiologies of cardioembolic stroke and the use of echocardiography in diagnosis and management are briefly discussed.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28713429/treatment-of-severe-refractory-hematuria-due-to-radiation-induced-hemorrhagic-cystitis-with-dexamethasone
#3
José Carlos Rodrigues Nascimento, Márcio Wilker Soares Campelo, Iuri Arruda Aragão, José Fernando Bastos de Moura, Lúcio Flávio Gonzaga Silva, Reinaldo Barreto Oriá
Treatment of pelvic neoplasms with radiotherapy may develop sequelae, especially RHC. An 85-year-old male patient was admitted to a hospital emergency with gross hematuria leading to urinary retention and was diagnosed with RHC. The urinary bladder was probed, unobstructed, and maintained in continuous three-way saline irrigation. During 45 days of hospitalization, the patient underwent two cystoscopic procedures for urinary bladder flocculation, whole blood transfusions, and one platelet apheresis. None of these interventions led to clinical resolution...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28684961/natural-history-of-invasive-papillary-breast-carcinoma-followed-for-10-years-a-case-report-and-literature-review
#4
Yong Joon Suh, Hyukjai Shin, Tae Jung Kwon
Diachronic research on untreated breast cancer completely depends on past medical records when no more recent, advanced methods are available. Herein, we report a case of invasive papillary breast carcinoma followed for 10 years in a 59-year-old woman who refused any treatment. The diagnosis was based on core needle biopsies. At the patient's first visit in July 2006, the tumor measured 10.4 × 7.2 × 3.5 cm. It was staged as IIIB (T4bN1). In May 2016, the tumor was staged as IIIC (T4bN3a). In the past 10 years, the tumor has increased to 12...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28656049/systemic-embolization-from-an-unusual-intracardiac-mass-in-the-left-ventricular-outflow-tract
#5
Kelechukwu U Okoro, Timothy R Larsen, John C Lystash
Endocarditis can affect any endocardial surface; in the vast majority of cases, the cardiac valves are involved. It is exceedingly rare to develop infective endocarditis on the endocardium of the left ventricular outflow tract due to the high velocity of blood that traverses this area. Herein, we present a rare case of left ventricular outflow tract endocarditis that likely occurred secondary to damage to the aortic valve leaflets (from healed prior aortic valve endocarditis) causing a high velocity aortic valve regurgitant jet that impinged upon the interventricular septum which damaged the endocardium and resulted in a fibrotic "jet lesion...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28642793/repair-of-thoracoabdominal-aortic-aneurysm-with-thrombosed-infrarenal-component-a-modified-hybrid-technique-without-aortic-cross-clamping
#6
Hussam Abou-Al-Shaar, Khaled J Zaza, Muhammad Anees Sharif, Samer Koussayer
The authors report the successful repair of a Crawford type III thoracoabdominal aortic aneurysm (TAAA) with a thrombosed infrarenal component using a modified hybrid technique without aortic clamping in a high-risk patient. A 64-year-old male with a history of hypertension, diabetes, and severe chronic obstructive pulmonary disease presented with acute on chronic backache and bilateral short distance claudication. A computerized tomography scan demonstrated a large, nonleaking Crawford type III TAAA with thrombosed infrarenal component of the aneurysm...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28634493/an-exceptional-case-of-intraparotid-plexiform-neurofibroma-originating-from-autonomic-fibers-of-the-auriculotemporal-nerve
#7
Sarantis Blioskas, Sotiris Sotiriou, Katerina Rizou, Triantafyllia Koletsa, Petros Karkos, Anna Kalogera-Fountzila, Konstantinos Markou
Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28620416/antiphospholipid-syndrome-multiple-manifestations-in-a-single-patient-a-high-suspicion-is-still-needed
#8
Uroosa Ibrahim, Shiksha Kedia, Gwenalyn Garcia, Jean Paul Atallah
Antiphospholipid Syndrome (APS) is an autoimmune disorder with clinical and laboratory features of vascular thrombosis, pregnancy loss, and persistent antiphospholipid antibodies (aPLs). The pathophysiology is thought to involve the activation of endothelial cells, monocytes, platelets, and complement by aPLs. Disease can range from asymptomatic to rapidly fatal catastrophic APS. We present a case of a 34-year-old male referred for pancytopenia and splenomegaly. On examination, he had decreased sensation and 4/5 power in the left upper extremity...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28620415/a-novel-surgical-technique-for-fixation-of-recurrent-acromioclavicular-dislocations-ac-dog-bone-technique-in-combination-with-autogenous-semitendinosus-tendon-graft
#9
Patrick Holweg, Wolfgang Pichler, Gerald Gruber, Ellen Tackner, Franz Josef Seibert, Patrick Sadoghi, Gloria Hohenberger
Various surgical techniques have been described for the fixation of acromioclavicular (AC) dislocations. However, recurrent dislocation is one of the main complications associated with the majority of these techniques. We report a case of postoperative AC joint redislocation. In order to overcome recurrent dislocation after revision surgery, a reconstruction of the conoid and trapezoid ligament with the use of a free tendon graft in combination with a FiberTape was provided within a novel surgical technique...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28607558/hashimoto-s-encephalopathy-presenting-with-unusual-behavioural-disturbances-in-an-adolescent-girl
#10
Murugan Selvaraj Karthik, Kulothungan Nandhini, Viswanath Subashini, Ramasamy Balakrishnan
Hashimoto's encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28588619/portal-hypertensive-biliopathy-presents-with-massive-bleeding-during-ercp-after-balloon-sphincteroplasty-in-a-noncirrhotic-saudi-sickler-patient
#11
Ahmad M Al-Akwaa, Mohammed Elsadig, Ahmed E Al-Fayaa, Mohja D Al-Shehri
Portal hypertensive biliopathy (PHB) is described as abnormalities of the walls of the biliary tree secondary to portal hypertension. Gastrointestinal bleeding caused by PHB is rare. PHB as a cause of serious bleeding after sphincteroplasty during ERCP is extremely rare. Here, we report a case of PHB in a young Saudi male with cell sickle anemia who developed massive hemorrhage during ERCP after balloon dilation of the ampulla of Vater. We further discussed the diagnosis and management. To the best of our knowledge, no such case has been reported...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28588618/ventilator-management-of-bronchopleural-fistula-secondary-to-methicillin-resistant-staphylococcus-aureus-necrotizing-pneumonia-in-a-pregnant-patient-with-systemic-lupus-erythematosus
#12
Ahmed F Alohali, Saleh Abu-Daff, Kamardeen Alao, Mohammed Almaani
Managing mechanical ventilation in patient with bronchopleural fistula with coexisting acute respiratory distress syndrome is a challenging situation for the intensivist. We are reporting a case of a pregnant patient with systemic lupus erythematosus on immunosuppressive medications who developed methicillin-resistant Staphylococcus aureus necrotizing pneumonia complicated by bronchopleural fistula and acute respiratory distress syndrome.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28567059/intraplacental-choriocarcinoma-rare-or-underdiagnosed-report-of-2-cases-diagnosed-after-an-incomplete-miscarriage-and-a-preterm-spontaneous-vaginal-delivery
#13
Rita Ferraz Caldas, Paula Oliveira, Cátia Rodrigues, Inês Reis, Horácio Scigliano, Rosete Nogueira, Célia Araújo, Soledade Ferreira
Intraplacental choriocarcinoma is a rare malignant tumor diagnosed after an abortion, an ectopic pregnancy, or a term or preterm pregnancy or following the diagnosis of a hydatidiform mole. During pregnancy, it may be more common than reported, as most patients are asymptomatic and placental choriocarcinomas are usually inconspicuous macroscopically and are often mistaken for an infarct. Based upon a case study methodology, we describe 2 cases of intraplacental choriocarcinoma: the first case was identified in the product of a uterine curettage following an incomplete miscarriage and the second in one of the placentas of a bichorionic twin pregnancy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28553356/asymptomatic-brain-edema-after-hemodialysis-initiation-in-a-patient-with-severe-uremia
#14
Kiichiro Fujisaki, Kaneyasu Nakagawa, Hiroshi Nagae, Toshiaki Nakano, Masatomo Taniguchi, Kosuke Masutani, Takanari Kitazono, Kazuhiko Tsuruya
A 66-year-old man with severe renal insufficiency presented with mild confusion associated with uremia. Cranial magnetic resonance imaging (MRI) showed no remarkable changes. The patient was placed on short-duration hemodialysis (2 hours) with smaller surface area and low blood flow (100 mL/min) to avoid dialysis disequilibrium syndrome (DDS). His consciousness gradually improved and he did not develop apparent DDS symptoms. However, T2-weighted FLAIR MRI showed increased signal intensities bilaterally in the cortical and subcortical areas of the occipital lobe on day 15...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28546813/a-case-of-urachal-carcinoma-of-the-abdominal-wall-in-a-kidney-transplant-recipient
#15
Takuya Yamazaki, Yasushi Nagaba, Yoshitaka Shimada, Yoshinori Taoka, Satoru Minamida, Dai Koguchi, Masahiro Hagiwara, Sho Watanuki, Hide Nagaba, Kazunari Yoshida, Yasuo Takeuchi
Urachal carcinoma is an extremely rare malignant tumor arising from the urachus in the fetus. We report a patient who developed urachal carcinoma 18 years after kidney transplantation. A 59-year-old man was admitted because of abdominal pain and massive ascites. He had undergone kidney transplantation 18 years earlier and had end-stage renal disease requiring dialysis. Abdominal CT showed massive ascites and an abdominal wall cystic mass separated from the peritoneal cavity. Hemodialysis was started, and paralytic ileus was diagnosed and treated...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28523071/forsaken-foregut-case-report-of-simultaneous-black-esophagus-and-ischemic-cholangiopathy
#16
Paul A Cameron, Franzjosef Schweiger
Black esophagus or acute esophageal necrosis rarely occurs after severe hemodynamic compromise or low-flow states. Other contributing factors may include corrosive injury from gastric contents and diminished mucosal repair mechanisms. Ischemic cholangitis, another rare clinical entity, is also usually the result of a significant vascular and/or hypotensive insult to the biliary tree. We describe the first case of combined acute esophageal necrosis and ischemic cholangiopathy in a 62-year-old male who completely recovered from the esophageal injury but developed progressive liver failure from ischemic cholangiopathy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28523070/a-curious-case-of-intestinal-diaphragm-disease-unmasked-by-perforation-of-a-duodenal-ulcer
#17
Mairéad McNally, Ion Cretu
Nonsteroidal anti-inflammatory drugs are a common cause of intestinal injury. A variety of NSAID-induced injuries may occur including ulcers, erosions, colitis, strictures, and diaphragm disease. Diaphragm disease refers to the development of multiple thin, concentric, stenosing strictures in the intestine. Strictures occur most often in the midintestine and are thought to be pathognomonic of NSAID damage. They can lead to intermittent or complete bowel obstruction. Diagnosis may be elusive as there is nothing specific about NSAID-induced injury at endoscopy and histology is also nonspecific...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487744/atorvastatin-diltiazem-combination-induced-rhabdomyolysis-leading-to-diagnosis-of-hypothyroidism
#18
N D B Ehelepola, S M B Y Sathkumara, H M P A G S Bandara, K L R Kalupahana
Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture. An elderly male who has been on atorvastatin for three years and on diltiazem for a week presented with sudden onset inability to walk and confusion. On examination muscle tenderness was noticed and creatine kinase levels indicated rhabdomyolysis which we attributed to atorvastatin...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487743/delirium-and-high-creatine-kinase-and-myoglobin-levels-related-to-synthetic-cannabinoid-withdrawal
#19
Ahmet Bulent Yazici, Esra Yazici, Atila Erol
Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2-100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487742/serum-cytokine-profile-in-a-patient-diagnosed-with-dysferlinopathy
#20
Svetlana F Khaiboullina, Ekaterina V Martynova, Sergey N Bardakov, Mikhail O Mavlikeev, Ivan A Yakovlev, Arthur A Isaev, Roman V Deev, Albert A Rizvanov
Limb-girdle muscular dystrophy type 2 (LGMD2B) is a mild form of dysferlinopathy, characterized by limb weakness and wasting. It is an autosomal recessive disease, with currently 140 mutations in the LGMD2B gene identified. Lack of functional dysferlin inhibits muscle fiber regeneration in voluntary muscles, the main pathological finding in LGMD2B patients. However, the immune system has been suggested to contribute to muscle cell death and tissue regeneration. Serum levels of 27 cytokines were evaluated in a dysferlinopathy patient...
2017: Case Reports in Medicine
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